To: Jean-Philippe Chevalier who wrote (4230 ) 7/18/1998 10:38:00 AM From: Cacaito Read Replies (1) | Respond to of 5736
Don Carlson, The creation of an outpatient bilirubin market with the early discharge of babies is real due to the pressures of insurers and hospitals, the average stay in hospital nurseries in the USA has come down from about 4.5 days to about 1.5 to 2.5 days. Babies are usually follow up within 2 to 4 weeks after discharge. New early (less than 72 hours)discharge trends are associated with the peak of bilirubin to happen at home, this will increase outpatient testing. The American Academy of Pediatrics is now recommending follow up within 2 to 3 days after early discharge for many reasons like nutrition, hydration and jaundice problems which are now proven to have increase with the early discharge policies. 85% of readmited babies in the first week of life is jaundice (high bilirubin). Dr Maisels works for CCSI, and you are very inappropriately suggesting that he is not humanitarian because he wants to stick all those healthy babies to find the one who will suffer the most. That is a fact, hundreds of babies are being stick for bilirubin testing and it is the common practice of many years, not design by Dr. Maisels. Quite the opposite, he is one of many working hard to avoid then getting stick due to the research on the Colormate. So, there is a new neeed to test babies as outpatients, maybe not a huge one but it does exist and growing. Some factors reduce this need. For example, babies and mothers blood types and Coombs (antibodies reactions against red cell test) are done at birth in many hospitals, (in NY city all hospitals do) and with this tests in hospital neonatologists could be more comfortable in many cases not to test certain babies or do just one bilirubin test in most of then. Most outpatient pediatricians will opt for testing (faster and less painful with the Colormate). This trends that I mentioned are important to determine what the outpatient market could be. Do you want the whole babblings go and read Clinics in Perinatology?