| Outcome and cost analysis of implementing selective Coombs testing in the newborn nursery. | |
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MedLine Citation:
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PMID: 22441112 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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.Journal of Perinatology advance online publication, 22 March 2012; doi:10.1038/jp.2012.26. |
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Authors:
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R Shahid; S Graba |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-3-22 |
Journal Detail:
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Title: Journal of perinatology : official journal of the California Perinatal Association Volume: - ISSN: 1476-5543 ISO Abbreviation: - Publication Date: 2012 Mar |
Date Detail:
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Created Date: 2012-3-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8501884 Medline TA: J Perinatol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Pediatrics, Loyola University Medical Center, Maywood, IL, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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