Frequency of neonatal bilirubin testing and hyperbilirubinemia in a large health maintenance organization.
OBJECTIVE
To determine the frequency and interhospital variation of bilirubin testing and identified hyperbilirubinemia in a large health maintenance organization.


METHODS
Retrospective cohort study.


METHODS
Eleven Northern California Kaiser Permanente hospitals.


METHODS
A total of 51,387 infants born in 1995-1996 at >/= 36 weeks' gestation and >/= 2000 g.


METHODS
Bilirubin tests and maximum bilirubin levels recorded in the first month after birth.


RESULTS
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%.


CONCLUSIONS
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.
Newman
T B
TB
Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, California 94143, USA. newman@itsa.ucsf.edu
Escobar
G J
GJ
Gonzales
V M
VM
Armstrong
M A
MA
Gardner
M N
MN
Folck
B F
BF
D002140:California / Q000453:epidemiology; D005006:Ethnicity; D005260:Female; D006279:Health Maintenance Organizations; D006801:Humans; D006932:Hyperbilirubinemia / Q000453:epidemiology* / Q000517:prevention & control*; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D012189:Retrospective Studies