United States Neonatology Practice Survey: Personnel, Practice, Hospital, and Neonatal Intensive Care Unit Characteristics

Pollack, Louis D.; Ratner, Ian; Lund, Greg C.

doi:10.1542/peds.101.3.398

Cited by 40 publications

(24 citation statements)

References 12 publications

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“…This assessment highlights availability and scope of services provided in neonatal units in Nigeria, each functioning at different levels of sophistication. The response rate of 95% was much higher than a similar survey in the US 12 . The respondents comprising mostly of doctors (85%) and female health workers, reflecting the composition of participants at this conference.…”

Section: Discussioncontrasting

confidence: 55%

Scope of neonatal care services in major Nigerian hospitals

Okonkwo¹,

Abhulimhen-Iyoha²,

Okolo³

2016

Nig. J. Paed.

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Section: Discussioncontrasting

confidence: 55%

Scope of neonatal care services in major Nigerian hospitals

Okonkwo¹,

Abhulimhen-Iyoha²,

Okolo³

2016

Nig. J. Paed.

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“…Historically, surveys of the neonatology workforce have focused on physician providers and have neither gathered data about NNPs, nor have they considered their potential impact on the overall neonatology workforce. [10][11][12] Although the number of fellows in training has increased significantly over the past decade, it is unclear whether additional neonatologists are necessary, based on clinical needs. 11,13 The impact of graduating fellows on the current or future NNP workforce is unknown.…”

Section: Introductionmentioning

confidence: 99%

A survey of the current neonatal nurse practitioner workforce

et al. 2008

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Objective: To assess the adequacy and characteristics of the US neonatal nurse practitioner (NNP) workforce.Study Design: Internet-based survey of 271 NNP conference participants. Data were analyzed using SPSS (version 14; Chicago, IL, USA); descriptive statistics, including w 2 -tests of independence, were performed (a ¼ 0.05).Result: Respondents were primarily masters-prepared females, working in level III newborn intensive care units. Unfilled NNP positions were common; time estimated to fill positions averaged 6-18 months. Onethird of the respondents' practice settings had substituted other providers. The mean NNP salary was $86 700. Motivators for becoming an NNP included autonomy and increased knowledge; challenges identified were overload of responsibilities and the NNP shortage. Conclusion:This study provides the first data about NNP education and workforce characteristics in the United States. The use of an internetbased data collection process facilitated the rapid response of a large sample of NNPs and demonstrated the effectiveness of this method of data collection. The results of this survey suggest a mismatch between the need for NNPs the available NNP workforce supply.

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“…3 This really should not come as much of a surprise since Pollack et al found that nationally, the distribution of neonatologists had little to do with the distribution of very low birth weight births. 4 This new system of perinatal care has additionally challenged the thought that an efficient system of perinatal care is one where high-risk patients are consolidated into the minimum number of costly perinatal centers. In California, community NICUs increased from 17 to 52 to care for fewer VLBW births.…”

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confidence: 99%

The New System of Perinatal Care

Hulsey

2002

J Perinatol

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In this issue of the Journal, Gould et al. describe the increase in the number of Level III hospitals, with the concomitant shift in patients, in California between 1990 and 1997. 1 Most dramatically, community NICUs increased largely as a result of being redesignated, or formally acknowledged, as a higher-acuity hospital. In California, the number of VLBW in large regional centers declined 34% (from 3044 to 2005) whereas the number of VLBW in community NICUs increased 182% (from 1017 to 2866).This paper serves as sobering evidence that traditional regionalized perinatal care, and much of the original guiding philosophy, have disappeared. The actions of the California hospitals and that of the California state agency that designates hospital level indicate that a new system of perinatal care has arrived. This new system has bluntly challenged apparently all the previously accepted performance standards.Published reports that optimal VLBW outcomes are achieved in hospitals with large volume level III NICUs have been disputed. 2 The old assumption that the health provider teams that cared for large numbers of high-risk patients were therefore more experienced and thus were able to obtain the optimal outcomes was also contested. In this study, there were substantial shifts in the location of delivery of VLBW newborns away from the large regional centers. This new system has also discounted the reasoning that the number of hospitals that are designated at each acuity level should in some way be reflective of the number of patients needing that particular level of care. In California, the number of VLBW births decreased by 9% whereas the number of NICUs increased by 19%. There were 208 neonatologists in California in 1990 and by 1997, this had increased to 509 (nationally, this increase was from 1588 to 3688). 3 This really should not come as much of a surprise since Pollack et al. found that nationally, the distribution of neonatologists had little to do with the distribution of very low birth weight births. 4 This new system of perinatal care has additionally challenged the thought that an efficient system of perinatal care is one where high-risk patients are consolidated into the minimum number of costly perinatal centers. In California, community NICUs increased from 17 to 52 to care for fewer VLBW births. These data provide dramatic evidence that the original tenets that guided the development of regionalized perinatal care are not contemporarily functional. Indeed, in California and elsewhere, the proliferation of neonatal intensive care programs has occurred in spite of published reports that such changes do not result in improved outcomes: either for the patient or the system of perinatal care. With supply (neonatologists) exceeding demand (high-risk newborns) and financial profitability an obvious certainty (otherwise why would so many hospitals be clamoring for level III status), more hospitals are entering the perinatal health care market place, regardless. If these new systems can redesign themselves reg...

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United States Neonatology Practice Survey: Personnel, Practice, Hospital, and Neonatal Intensive Care Unit Characteristics

Abstract: Significant discrepancies between earlier projected neonatologist requirements and current neonatology workforce and service responsibilities are discussed in relation to demands of reallocation of subspecialty resources within an evolving health care system.

Cited by 40 publications

References 12 publications

Scope of neonatal care services in major Nigerian hospitals

Scope of neonatal care services in major Nigerian hospitals

A survey of the current neonatal nurse practitioner workforce

The New System of Perinatal Care

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