Document Detail

Outcome and cost analysis of implementing selective Coombs testing in the newborn nursery.
MedLine Citation:
PMID:  22441112     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: (1) To determine whether infants born to O+ mothers who had selective cord-blood testing would have higher rates of clinically significant hyperbilirubinemia compared with those newborns who had routine cord-blood testing. (2) To determine the amount of cost savings by implementing a policy of selective cord-blood testing in newborns born to O+ mothers.
STUDY DESIGN: We conducted a retrospective pre/post intervention chart review on all infants in the normal newborn nursery at Loyola, born to blood type O+ women between 1 April 2008 and 1 April 2009. The pre-intervention group (routine testing) included infants born within 6 months before implementation of a new policy. The post-intervention group (selective testing) included infants born within 6 months following the implementation of a new policy. Data were collected for each of these groups regarding clinically significant hyperbilirubinemia.
RESULT: All 250 of the infants in the routine testing group had a cord-blood type and Coombs done, whereas 42 of 164 (25%) infants in the selective group had testing done. By the end of the 6 months following the policy change, only 8% of infants were undergoing cord testing. When comparing routine vs selective testing, there was no statistically significant difference in the 24-h serum bilirubin, rate of phototherapy during the birth hospitalization, rate of readmission for hyperbilirubinemia or peak serum bilirubin level at readmission. The 92% reduction of cord-blood typing and Coombs testing would lead to a cost saving of $4100 per year to our hospital and $18 900 per year to our patients, and 95 h per year of technician time to perform these tests. When extrapolated to Illinois births in 2008, this would lead to an annual cost saving of almost $800 000 to Illinois hospitals and about $3.6 million to patients.
CONCLUSION: Selective newborn cord testing of infants born to O+ mothers can decrease the use of resources and costs without increasing the risk of clinically significant hyperbilirubinemia.
R Shahid; S Graba
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2012-03-22
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  32     ISSN:  1476-5543     ISO Abbreviation:  J Perinatol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-29     Completed Date:  2013-06-04     Revised Date:  2013-08-20    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  966-9     Citation Subset:  IM    
Department of Pediatrics, Loyola University Medical Center, Maywood, IL 60153, USA.
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MeSH Terms
ABO Blood-Group System*
Blood Group Incompatibility / blood*,  diagnosis
Cohort Studies
Coombs Test / economics*,  statistics & numerical data*
Cost Savings
Cost-Benefit Analysis
Fetal Blood
Hyperbilirubinemia / blood*,  diagnosis
Infant, Newborn
Neonatal Screening / methods
Nurseries, Hospital
Outcome Assessment (Health Care)
Retrospective Studies
United States
Reg. No./Substance:
0/ABO Blood-Group System
Comment In:
J Perinatol. 2013 Jul;33(7):579   [PMID:  23803682 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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