Community bilirubin monitoring evaluated in selected newborns after hospital discharge

Neonatal jaundice often peaks after hospital discharge, requiring reliable follow-up. A retrospective observational study in northeastern Italy evaluated a structured pathway using the Bilistick® System 2.0 for point-of-care bilirubin testing within Community Health Family Services (CHFS). Of 397 eligible newborns, 244 were included. Referral to community or hospital follow-up depended on bilirubin risk, clinical factors, and organizational considerations; the study assessed pathway feasibility and safety.

Among included newborns, 108 (44.3%) were referred to CHFS, 135 (55.3%) to hospital follow-up, and one was lost to follow-up. In the CHFS group, 97 (89.8%) completed monitoring without hospital referral. Eleven required hospital referral, including seven who received phototherapy. Among those referred directly to hospital follow-up, six (4.4%) required phototherapy. No sampling-related adverse events, missed phototherapy, exchange transfusions, or kernicterus were recorded.

The findings support the feasibility of community monitoring for selected low-risk newborns within a structured escalation pathway. However, retrospective selection, differing referral criteria, and the small cohort limit comparisons between settings and conclusions about rare adverse outcomes. Local administrative estimates indicated a direct cost difference of €32.30 per bilirubin reassessment, but this should not be interpreted as a comprehensive cost-effectiveness assessment.