Cost of Transcutaneous Bilirubinometry Study
M. Jeffrey Maisels and Elizabeth Kring
Transcutaneous Bilirubinometry Decreases the Need for Serum Bilirubin Measurements and Saves Money
Pediatrics 1997 99(4): 599.
From multiverse.com :
"JOURNAL WATCH"
GENERAL ACADEMIC PEDIATRICS
MAY, 1997
PEDIATRICS (VOL. 99, NO. 4)
.......... Transcutaneous Bilirubinometry (TcB) Decreases the Need for Serum Bilirubin Measurements - A group from Michigan sought to determine whether the introduction of a transcutaneous bilirubinometer (a device which non-invasively measures serum bilirubin level) would reduce the need for serum bilirubin measurements and associated cost in healthy, full-term infants.
In essence, they compared the number of serum bilirubin determinations and associated costs before and after the introduction of TcB in a large well baby nursery.
Despite the equipment cost of $3000, overall cost was reduced by $1600 per year related to reduction in the number of serum bilirubin levels obtained.
There was a 40% reduction in the number of infants having 1 serum bilirubin determination and a 56% reduction in infants having 2 serum levels drawn.
In addition, the number of serum bilirubin levels less than 10 mg./dL decreased from 46% to 27% of the total studies obtained.
TcB appears to be a worthwhile investment for large well baby nurseries.(end)
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Please Note:
-Dr. Maisels is one of the authors of this article. He was recently appointed to CCSI's medical advisory board:
Message 3033543 - News - 12/23/97
Message 3033819 - Info on Dr. Maisels
-This study was focused on healthy, full-term infants.
(Not premature infants and/or any in a neonatal intensive care unit. It also did not account for use in the home or Pediatricians' offices):
From exchange2000.com - Due Diligence on Frequency Of Hyperbilirubinemia For Premature Infants:
....Nearly all premature infants are monitored extensively for hyperbilirubinemia. According to MEDICAL SYSTEMS DATA STUDY "the average length of monitoring in the hospital is 11 days and the average number of TSB tests is 3 per day. The recommended treatment of phototherapy for premature infants is well under 12 mg/dl of TSB."
From exchange2000.com - Conference Call Transcript 8/12/97:
.....However a few things have happened that we believe are to our advantage in the medical distribution environment over the past year. First let me explain that we originally thought we had 2 potential markets in 4 geographic locations - the Hospital Market and the Pediatricians Office Market - in the U.S., Europe, South America and Asia locations.
However, in the past year a new and we believe a very large third potential market opened up - the Home Health Care Market. This is due to the early discharge of babies and mothers from the hospital and has changed many factors in our potential marketing opportunities, in a positive way.
The Home Health Care Distributors have been providing for the increasing need for bilirubin monitoring by the visiting nurse or techician sent to the home but the Home Health Care Distributors are experiencing an even greater need to provide the parents with a screening device for bilirubin at home.
......Currently the instructions to parents as they leave the hospital are "watch and see if your baby gets an increased yellow cast to the skin" - well you can imagine the obvious problems - especially for the Hispanic, Black or Asian children.
So two problems have emerged - either the parents have been constantly calling and a visiting nurse must go to the home, only to discover no problem in the first place, which is a very expensive trip for the Home Health Care Medical Distribution Company. Or in the case of parents' uncertainty or inadequate care, the baby is being brought in days later - very yellow and in danger of potential central nervous system damage.
The #1 reason for babies being readmitted to hospitals after discharge today is bilirubin infant jaundice. It's a big problem for the medical community. And of course this market is only a new and incremental one to the well established market existing in the hospitals, clinics and the traditional medical community, where non-invasive monitoring would be of great value to physicians in management of patient care. |
