Volumen- und Ausstattungsmerkmale als peri- und neonatale Qualitätsindikatoren: Eine Übersicht über Daten der letzten 4 Jahre

Poets, Christian F.; Bartels, Dorothee B.; Wallwiener, D.

doi:10.1055/s-2004-835868

Cited by 10 publications

(7 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A promising approach to better predict the treatment quality of a given clinic is the examination of the most current mortality and morbidity data, which largely remain constant over time (5,6). These data have the highest predictive value for estimating future survival quality.…”

Section: Discussionmentioning

confidence: 99%

“…These data have the highest predictive value for estimating future survival quality. Poets et al remarked: ‘This would at least avoid situations in which a large clinic with poor treatment outcomes continues to attract many patients, while a small neighbouring clinic with good outcomes is in danger of being closed’ (5).…”

Section: Discussionmentioning

confidence: 99%

“…This success can be measured with direct quality indicators such as mortality and morbidity, which also enable a comparison of treatment centres in relation to the case mix (severity of treated diseases). The attempt to predict treatment quality for individual centres by evaluating indirect quality indicators has met with only limited success (5,6). For instance, the indirect quality indicator ‘patient volume per time and treatment unit’ predicts merely 9% of the intercentre variability (6).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Quality of care of VLBW neonates: relationship between unit volume and outcome is different between metropolitan and rural regions

et al. 2008

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Quality of care of VLBW neonates: relationship between unit volume and outcome is different between metropolitan and rural regions

et al. 2008

View full text Add to dashboard Cite

show abstract

“…The impact of case-volume and/or perinatal regionalisation on neonatal and/or maternal outcomes after healthy pregnancy is in the focus of current research but shows inconsistent results. [37][38][39] Therefore, an updated SR seems to be necessary to overcome the methodological limitations in already published SRs and to include additional clinical and patient-reported outcomes.…”

Section: Main Findingsmentioning

confidence: 99%

Impact of regionalisation and case-volume on neonatal and perinatal mortality: an umbrella review

et al. 2020

View full text Add to dashboard Cite

ObjectiveThis umbrella review summarises and critically appraises the evidence on the effects of regulated or high-volume perinatal care on outcome among very low birth weight/very preterm infants born in countries with neonatal mortality <5/1000 births.Intervention/expositionPerinatal regionalisation, centralisation, case-volume.Primary outcomesDeath.Secondary outcomesDisability, discomfort, disease, dissatisfaction.MethodsOn 29 November 2019 a systematic search in MEDLINE and Embase was performed and supplemented by hand search. Relevant systematic reviews (SRs) were critically appraised with A MeaSurement Tool to Assess systematic Reviews 2.ResultsThe literature search revealed 508 hits and three SRs were included. Effects of perinatal regionalisation were assessed in three (34 studies) and case-volume in one SR (6 studies). Centralisation has not been evaluated. The included SRs reported effects on ‘death’ (eg, neonatal), ‘disability’ (eg, mental status), ‘discomfort’ (eg, maternal sensitivity) and ‘disease’ (eg, intraventricular haemorrhages). ‘Dissatisfactions’ were not reported. The critical appraisal showed a heterogeneous quality ranging from moderate to critically low. A pooled effect estimate was reported once and showed a significant favour of perinatal regionalisation in terms of neonatal mortality (OR 1.60, 95% CI 1.33–1.92). The qualitative evidence synthesis of the two SRs without pooled estimate suggests superiority of perinatal regionalisation in terms of different mortality and non-mortality outcomes. In one SR, contradictory results of lower neonatal mortality rates were reported in hospitals with higher birth volumes.ConclusionsRegionalised perinatal care seems to be a crucial care strategy to improve the survival of very low birth weight and preterm births. To overcome the low and critically low methodological quality and to consider additional clinical and patient-reported results that were not addressed by the SRs included, we recommend an updated SR. In the long term, an international, uniformly conceived and defined perinatal database could help to provide evidence-based recommendations on optimal strategies to regionalise perinatal care.PROSPERO registration numberCRD42018094835.

show abstract

“…국내 연구 자들은 NICU의 인력 부족과 지역별 의료 공급 불균형, 비효율적 의 료 전달체계를 이구동성으로 말한다 7,11,12) . 특히 VLBWI의 생존율과 예후 향상을 위해서는 소위 "golden minutes"라고 불리는 출생 직후 Care에 따라 각각 level I (well newborn nursery), II (special care nursery), III (NICU), IV (regional NICU)로 구분하였다 14) 50%-59% 60%-69% 70%-79% 80%-89% 90%-99% 100%-120% >120% [22][23][24][25][26][27][28] . 이 결과는 미숙아 사망 연관 교란변수를 보정 한 최근의 메타분석에서도 확인된다 29) .…”

unclassified

Current Status of Neonatologist Staffing and Workload in Korean Neonatal Intensive Care Units

Lee¹,

Lim²,

Choi³

et al. 2020

Neonatal Med

View full text Add to dashboard Cite

Purpose: To identify the recent status of the neonatologist and their workload in neonatal intensive care unit (NICU) in Korea. Methods: On October 2018, a survey was conducted on the statistics of the workforce including the census of certified neonatologists, NICU beds, nursing staffing ratings, bed occupancy rate, annual admission of very low birth weight infant (VLBWI), infant acuity score of nursing, and the proportion of out-born patients. The level of neonatal care was self-rated. Results: A total of 68 centers responded to the survey. An average number of cer tified neonatologists and the number of NICU beds per center was 1.9 (range, 0 to 5) and 23.1 (range, 0 to 30), respectively. Thirty-eight percent (n=26) of NICUs were being operated with only one (n=24) or no (n=2) certified neonatologist and only 19% (n=13) of NICUs had ≥3 neonatologists. The average ratio of NICU beds to neonatologists rated 13.4±6.2. The higher the level of neonatal care, the higher the number of tertiary referral hospitals, neonatologists, NICU volume, infant acuity scores of nursing, and annual VLBWI admissions. However, there was no difference in the beds to neonatologist ratio between level 2 (n=9, 9.5±3.1), level 3 (n=44, 14.0± 6.9), and level 4 (n=14, 13.7±4.2). The infant acuity score was proportional to the NICU volumes, but not related to the beds to neonatologist ratio. Conclusion: Compared with the international standards, most Korean NICUs were understaffed in terms of the certified neonatologist and were unable to provide 'continuity of care' for high-risk newborns.

show abstract

Volumen- und Ausstattungsmerkmale als peri- und neonatale Qualitätsindikatoren: Eine Übersicht über Daten der letzten 4 Jahre

Cited by 10 publications

References 17 publications

Quality of care of VLBW neonates: relationship between unit volume and outcome is different between metropolitan and rural regions

Quality of care of VLBW neonates: relationship between unit volume and outcome is different between metropolitan and rural regions

Impact of regionalisation and case-volume on neonatal and perinatal mortality: an umbrella review

Current Status of Neonatologist Staffing and Workload in Korean Neonatal Intensive Care Units

Contact Info

Product

Resources

About