Frequency of neonatal bilirubin testing and hyperbilirubinemia in a large health maintenance organization

To determine the frequency and interhospital variation of bilirubin testing and identified hyperbilirubinemia in a large health maintenance organization. Retrospective cohort study. Eleven Northern California Kaiser Permanente hospitals. A total of 51,387 infants born in 1995-1996 at >/= 36 weeks...

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Bibliographic Details
Published in:Pediatrics (Evanston) 1999-11, Vol.104 (5), p.1198-1203
Main Authors: NEWMAN, T. B, ESCOBAR, G. J, GONZALES, V. M, ARMSTRONG, M. A, GARDNER, M. N, FOLCK, B. F
Format: Article
Language:English
Subjects:
Biological and medical sciences
California - epidemiology
Delivery. Postpartum. Lactation
Diagnosis
Ethnic Groups
Female
Gynecology. Andrology. Obstetrics
Health Maintenance Organizations
HMOs
Humans
Hyperbilirubinemia
Hyperbilirubinemia - epidemiology
Hyperbilirubinemia - prevention & control
Infant, Newborn
Infants (Newborn)
Male
Mass Screening - utilization
Maternal, fetal and perinatal monitoring
Medical disorders
Medical sciences
Neonatal jaundice
Newborn infants
Pediatrics
Retrospective Studies
Testing
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Summary:To determine the frequency and interhospital variation of bilirubin testing and identified hyperbilirubinemia in a large health maintenance organization. Retrospective cohort study. Eleven Northern California Kaiser Permanente hospitals. A total of 51,387 infants born in 1995-1996 at >/= 36 weeks' gestation and >/= 2000 g. Bilirubin tests and maximum bilirubin levels recorded in the first month after birth. The proportion of infants receiving >/= 1 bilirubin test varied across hospitals from 17% to 52%. The frequency of bilirubin levels >/= 20 mg/dL (342 micromol/L) varied from .9% to 3.4% (mean: 2.0%), but was not associated with the frequency of bilirubin testing (R(2) = .02). Maximum bilirubin levels >/= 25 mg/dL (428 micromol/L) were identified in.15% of infants and levels >/= 30 mg/dL (513 micromol/L) in .01%. Significant interhospital differences exist in bilirubin testing and frequency of identified hyperbilirubinemia. Bilirubin levels >/=20 mg/dL were commonly identified, but levels >/= 25 mg/dL were not.
ISSN:0031-4005
1098-4275