Screening for Severe Neonatal Hyperbilirubinemia

Vinod K. Bhutani


Pediatr Health. 2009;3(4):369-379. 

In This Article

Cost of Testing

The actual cost of a TB measurement, when carried out at metabolic screen, is due to the laboratory assay of an additional aliquot of a blood sample. This costs the institution usually less than US $1. On the other hand, any additional neonatal blood drawn from the heel using a micro-lancet is dependent on individual institutional charges. The costs for TcB measurements are the capital cost of the device (ranges: US$2000-4000) and that for the disposable probes (for calibration and hygiene) at approximately US $5. Additional costs for TB measurements are related to ensuring accuracy, since the reproducibility of this measurement in the clinical laboratory is occasionally erratic and attributed to problems with sampling, handling or assay methodology. To address these concerns regarding standardization, the College of American Pathologists conducts a Neonatal Bilirubin and a Chemistry survey every 4 months to provide each participating laboratory with an assessment of its bilirubin calibration performance.[39] In order to recommend routine bilirubin testing for every newborn, it is essential that measurements of both TB and TcB devices are calibrated to nationally acceptable standards.[40] Based on internal reviews, four major 'for-profit' healthcare organizations have voluntarily implemented universal predischarge bilirubin screening.[15] However, public health cost-effectiveness of universal bilirubin screening either as an institutional program or a statewide public health endeavor has not been determined.


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