{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T16:56:38Z","timestamp":1776185798936,"version":"3.50.1"},"reference-count":23,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neonatology"],"abstract":"<jats:p>Introduction: Neonatal jaundice is a leading cause of early post-discharge referrals. Community follow-up commonly relies on visual assessment and clinic-based evaluation, generating avoidable visits. Scalable home pathways that maintain safety are needed. We evaluated a nurse-led home pathway that integrates transcutaneous bilirubin (TcB) screening with targeted pediatric teleconsultation. Methods: A prospective before-after study was conducted within routine nurse-led home visits for eligible infants (firstborn or preterm) \u226535 weeks of gestation. A 3-month pre-intervention phase (usual visual assessment) was compared with a 9-month intervention using TcB-guided thresholds and teleconsultation via a secure digital platform. The primary analysis targeted infants who, under usual care, would be referred (\u201cbaseline-eligible\u201d), estimating the absolute difference in referral at the home visit. Secondary outcomes were agreement between clinical cues and TcB, teleconsultation utilization, and phototherapy requirement. Results: A total of 1,236 infants were enrolled (157 pre-intervention; 1,079 intervention). Among baseline-eligible infants (n = 840), 152 (18.1%) were referred; thus, 688\/840 (81.9%) potential referrals were avoided (absolute reduction 81.9%; 95% CI 79.2\u201384.4; NNR 1.22, 95% CI 1.19\u20131.26). TcB identified all infants requiring phototherapy (4\/1,079; 0.4%) within 14 days. Agreement between clinical cues and TcB-defined need for follow-up was slight (weighted \u03ba = 0.075; 95% CI 0.059\u20130.091). The reduction in referrals corresponded to an absolute decrease of 0.67 visits per infant. Conclusions: A nurse-led, digitally supported home pathway that integrates TcB screening and targeted teleconsultation substantially reduces unnecessary neonatal referrals, with no missed cases requiring phototherapy. This pragmatic precision-triage model is implementable within existing community services and can relieve post-discharge system burden while preserving safety.<\/jats:p>","DOI":"10.1159\/000550875","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T14:51:10Z","timestamp":1770648670000},"page":"1-9","source":"Crossref","is-referenced-by-count":0,"title":["Home-Based Transcutaneous Bilirubin Screening and Telemedicine Reduce Neonatal Referrals"],"prefix":"10.1159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7873-5224","authenticated-orcid":false,"given":"Sagee","family":"Nissimov","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nili","family":"Haas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia","family":"Habib","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Batia","family":"Madjar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deena R.","family":"Zimmerman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariela","family":"Hazan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Daniel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matitiahu","family":"Berkovitch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elkana","family":"Kohn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JPEDS.2012.08.022"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-17933-2"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.2196\/37843"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PONE.0320767"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1055\/A-2024-1145"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002958.PUB2"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1542\/PEDS.2022-058859"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1542\/PEDS.2008-2926"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1111\/APA.15096"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1542\/PEDS.107.6.1264"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1542\/PEDS.106.2.E17"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1542\/PEDS.2011-0599"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.semperi.2021.151430"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1542\/PEDS.103.1.6"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1542\/PEDS.2021-055553"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1136\/BMJPO-2023-002242"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-023-03969-4"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PONE.0320067"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1136\/BMJOPEN-2020-048145"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/J.JPEDS.2007.11.003"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1038\/S41372-020-00901-X"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2012.02.018"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1038\/S41390-024-03081-Y"}],"container-title":["Neonatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000550875","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T16:00:55Z","timestamp":1776182455000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000550875"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,9]]},"references-count":23,"URL":"https:\/\/doi.org\/10.1159\/000550875","archive":["Portico"],"relation":{},"ISSN":["1661-7800","1661-7819"],"issn-type":[{"value":"1661-7800","type":"print"},{"value":"1661-7819","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,9]]}}}