Home and in-hospital phototherapy as comparable select routine approach for neonatal hyperbilirubinemia.

The aim of this study was to compare home phototherapy and in-hospital phototherapy as a selected routine treatment approach for neonatal hyperbilirubinemia. A Clinical overview. Neonates included in home phototherapy were a carefully selected subgroup of late preterm and term neonates without risk factors for neurotoxic hyperbilirubinemia. The efficacy of home phototherapy and in-hospital phototherapy was comparable. Main advantages of home therapy over in-hospital treatment are that the neonates are not separated from their parents, and that it allows holistic family-centered care. Home phototherapy improves parent-neonate attachment and bonding, decreases parental stress, improves parental well-being. Parents reported positive experiences, feeling secure in caring for their neonate and in adjusting to parenthood. Phototherapy and breastfeeding did not need to be interrupted. Both parental and nursing satisfaction were high. The health care expenditures were reduced. The disadvantage of home phototherapy is that direct support from health care providers is diminished. Treatment failure included readmission to hospital and poor compliance. The readmission rate following home phototherapy was low. Home phototherapy was used both as initial treatment and following initial intensive in-hospital phototherapy. Conclusion: Home phototherapy is effective, feasible and safe, and reduces health care expenditures. It is a good routine alternative to in-hospital phototherapy. IMPACT: Home phototherapy is effective, feasible, and safe, and reduces health care expenditures. The efficacy of home- and in-hospital treatment is comparable. With appropriate patient selection and monitoring strategies, home phototherapy may represent a feasible treatment option not only in high-income countries, but also in diverse health care systems worldwide.