Transcutaneous bilirubinometry in the context of early postnatal discharge
Conseil d'Evaluation des Technologies de la Sante
Record ID 32001000053
This report aims to examine the usefulness of providing each region in Quebec with transcutaneous bilirubinometers. These devices are used to screen for the presence of jaundice in newborns, a sign of an elevated blood bilirubin level. This report evaluates the performance of these devices, their benefits and the economic and organizational implications of purchasing them and using them in the context of early postnatal discharge.
This assessment report brings out the importance of making early postnatal discharge part of a perinatal program that includes a systematic, early visit (no later than the third day after discharge from hospital) to the mother and infant. Since transcutaneous bilirubinometry is effective in detecting cases where a serum bilirubin measurement is required, making this technology part of a well-established perinatal program presents numerous benefits that could offset the costs associated with it.
However, even if transcutaneous bilirubinometry may play a useful role, the published data on this technology are insufficient to recommend a wide-scale program for the systematic purchase of these devices. The appropriateness of using transcutaneous bilirubinometry must therefore be assessed by the regional and local authorities on the basis of the following: - The benefit of an objective measurement of the degree of jaundice, which is especially useful outside hospitals. - The considerable ease of use in different settings. - The instrument's relatively high cost. - The limited or zero effectiveness of the most commonly used models in certain circumstances (highly multiethnic population, during treatment by way of phototherapy or exchange transfusion) compared to more recent models. - The need for strict quality control for its utilization, for assessing its long-term effectiveness and for adequate user training. - The need to assess, at the local level, the budget impact of purchasing one or more instruments.
English language abstract:
An English language summary is available
- Infant, Newborn
- Neonatal Screening
Conseil d'Evaluation des Technologies de la Santé du Québec
Conseil d'Evaluation des Technologies de la Santé du Québec, 2021, avenue Union, #1040, Montréal, Québec H3A S29, Canada. Tel: 514-873-2563; FAX: 514-873-1369
Conseil d'Evaluation des Technologies de la Sante du Quebec (CETS)