TABLE 5

Value Analysis of Implementing Neonatal Jaundice Clinical Pathway

DimensionCare Option ACare Option BPreferred Option
Population: hospitalized patients with newborn jaundice (n = 60 –> 50/y)Nonstandard carePathway care
Operational factors
 Percent adherence to care (goal 80%)Not predictableOver 80%
 Care delivery team effectsBaselineMore time to check irradiance, new equipment, lower length of stayOption B once equipment available
 Palatability to patient/familyBaselineLower length of stayOption B
Benefits
 Degree of recovery at dischargeNo differenceNo differenceNeutral
 Affects natural history of the diseaseBaselineReduces timeOption B
 Population-related benefitsNoneNoneNeutral
 Threshold for population-related benefits reachedNANA
Cost (arising from options A or B)
 Room/care setting costs ($ or time to recovery)$3699 (60 admissions/y)$2423 (50 admissions/y)Option B
 Diagnosis/Treatment costs ($)IV fluids: $145IV fluids: $57Option B
Laboratory $559Laboratory $370
Cost (complications/adverse effects arising from options A or B)
 Likelihood of complicationNo differenceNo differenceNeutral
 Cost of differential care per patient$4403$2850 per dischargeOption B
Annual estimated cost for this care$264 180$142 500 (10 avoided admissions)Option B