American Academy of Pediatrics 2022 Phototherapy Thresholds Reduce the Hospitalizations and the Associated Costs.

INTRODUCTION

The latest American Academy of Pediatrics guidelines for managing jaundice in late preterm and term neonates have increased the bilirubin thresholds to start phototherapy. This was considered safe based on expert consensus, but its cost-effectiveness has not yet been evaluated.

METHODS

This was a before-and-after, quality improvement and pharmaco-economical evaluation of hospital financial data from a perinatal academic referral centre.

RESULTS

Implementing the new guidelines decreased hospitalizations due to phototherapy by 68.7%, 70.2%, and 60% for the total population and the late preterm and term subgroups, respectively (p < 0.001 for the three analyses). The hospitalization costs were decreased from EUR 1,289,040 to EUR 423,120 (i.e., an absolute saving of EUR 865,920, or ≈68%, for the entire population composed by late preterm and term neonates). Implementing the new treatment threshold nationwide would entail an estimated cost reduction of EUR 191,964,324.

CONCLUSIONS

The new jaundice guidelines significantly decreased the use of phototherapy and associated healthcare costs.