{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T23:46:37Z","timestamp":1790293597040,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T00:00:00Z","timestamp":1645660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate a large midwifery\u2010led, paediatrician\u2010overseen home jaundice surveillance and home phototherapy (HPT) programme.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective cohort study over 2019. Included were all infants with birth gestation \u226535\u2009weeks, discharged at 4\u201396\u2009h and receiving care from midwifery\u2010at\u2010home (a 12\u2010h daily, 365\u2010days hospital\u2010based outreach service, supported by hospital paediatricians). Phototherapy was delivered via BiliSoft blanket with treatment thresholds determined by standard nomograms. The main outcomes of interest were unplanned readmissions, and cost\u2010effectiveness based on hospital finance department actual costs. Also examined were parental compliance, device issues and safety.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During 2019, 4308 infants received home jaundice surveillance with 86% hospital\u2010discharged before 72\u2009h, 82% exclusively breastfed and 69% having overseas\u2010born mothers. Four hundred infants received HPT, comprising 101 continuing from inpatient phototherapy (IPT), 56 rebounding after IPT, and 243 home\u2010diagnosed as needing phototherapy and triaged to HPT. Only 1 of 400 (0.25%) HPT infants required readmission. Additionally, there were 80 home\u2010diagnosed jaundiced infants triaged to immediate readmission for IPT. Maximal serum bilirubin was 454\u2009\u03bcmol\/L. No exchange transfusion, encephalopathy or HPT\u2010device problems occurred. An early 2019 bilirubin analyser upgrade resulted in higher bilirubin readings and some unintended subthreshold phototherapy. Supported by midwives, most parents managed HPT with ease. HPT cost $640\/day compared to $2100\/day for infant IPT readmission and $1000\/day for a longer birth\u2010admission stay. Up to 2\u2009weeks' midwifery\u2010at\u2010home care for the whole cohort cost $2\u2009m less than a 2\u2010day longer birth\u2010admission stay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Large\u2010scale, midwifery\u2010led, paediatrician\u2010overseen jaundice surveillance and HPT can achieve very low unplanned readmission rates and be cost\u2010effective.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.15925","type":"journal-article","created":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T10:44:49Z","timestamp":1645699489000},"page":"1159-1167","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Clinical outcomes and cost\u2010effectiveness of large\u2010scale midwifery\u2010led, paediatrician\u2010overseen home phototherapy and neonatal jaundice surveillance: A retrospective cohort study"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0648-7871","authenticated-orcid":false,"given":"Marjan","family":"Khajehei","sequence":"first","affiliation":[{"name":"Department of Women's and Newborn Health Westmead Hospital  Sydney New South Wales Australia"},{"name":"School of Women's and Children's Health University of New South Wales  Sydney New South Wales Australia"},{"name":"Westmead Clinical School The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beata","family":"Gidaszewski","sequence":"additional","affiliation":[{"name":"Department of Women's and Newborn Health Westmead Hospital  Sydney New South Wales Australia"},{"name":"Westmead Clinical School The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Maheshwari","sequence":"additional","affiliation":[{"name":"Westmead Clinical School The University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Neonatology Westmead Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Therese M","family":"McGee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Westmead Hospital  Sydney New South Wales Australia"},{"name":"Sydney Medical School Westmead The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.76.4.579"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/000992288602500601"},{"key":"e_1_2_7_4_1","first-page":"435","article-title":"Home phototherapy with the fiberoptic blanket. The nurse's role in caring for newborns and their caregivers","volume":"10","author":"Savinetti\u2010Rose B","year":"1990","journal-title":"J. Perinatol."},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1754.1995.tb02903.x"},{"key":"e_1_2_7_6_1","article-title":"Fibreoptic phototherapy for neonatal jaundice","author":"Mills J","year":"2001","journal-title":"Cochrane Database Syst. Rev."},{"key":"e_1_2_7_7_1","article-title":"Light\u2010emitting diode phototherapy for unconjugated hyperbilirubinaemia in neonates","author":"Kumar P","year":"2011","journal-title":"Cochrane Database Syst. Rev."},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1071\/AH000162"},{"key":"e_1_2_7_9_1","article-title":"Home\u2010versus hospital\u2010based phototherapy for the treatment of non\u2010haemolytic jaundice in infants at more than 37\u2009weeks' gestation","author":"Malwade U","year":"2014","journal-title":"Cochrane Database Syst. Rev."},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo-2021-001027"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2020.01.004"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-021-03932-4"},{"key":"e_1_2_7_13_1","unstructured":"National Collaborating Centre for Women's and Children's Health.Neonatal Jaundice. London: Royal College of Obstetricians and Gynaecologists; 2010. Available from:https:\/\/www.nice.org.uk\/guidance\/cg98\/evidence\/full-guideline-245411821[accessed 17 September 2021]."},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.114.1.297"},{"key":"e_1_2_7_15_1","unstructured":"New South Wales HealthJaundice Identification and Management in Neonates \u2265 32 Weeks Gestation GL2016_0272016. Sydney: NSW Government; 2016. Available from:https:\/\/www1.health.nsw.gov.au\/pds\/ActivePDSDocuments\/GL2016_027.pdf[accessed 17 September 2021]."},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jnn.2016.08.001"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13052-019-0663-5"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.15317"},{"key":"e_1_2_7_19_1","unstructured":"Australian Government Independent Hospital Pricing Authority.Activity Based Funding. Darlinghurst: Independent Hospital Pricing Authority (IHPA);2019. Available from:https:\/\/www.ihpa.gov.au\/what-we-do\/activity-based-funding[accessed 15 September 2021]."},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-2388"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2012.08.022"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.4944"}],"container-title":["Journal of Paediatrics and Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.15925","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jpc.15925","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.15925","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T04:21:13Z","timestamp":1692850873000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jpc.15925"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,24]]},"references-count":21,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1111\/jpc.15925"],"URL":"https:\/\/doi.org\/10.1111\/jpc.15925","archive":["Portico"],"relation":{},"ISSN":["1034-4810","1440-1754"],"issn-type":[{"value":"1034-4810","type":"print"},{"value":"1440-1754","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,24]]},"assertion":[{"value":"2021-09-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}