Parmanum J, Field D, Rennie J, Steer P
Department of Child Health, Robert Kilpatrick Clinical Sciences Building, University of Leicester, Leicester LE2 7LX.
BMJ. 2000 Sep 23;321(7263):727-9. doi: 10.1136/bmj.321.7263.727.
To determine whether availability of neonatal intensive care cots is a problem in any or all parts of the United Kingdom.
Three month census from 1 April to 30 June 1999 comprising simple data sheets on transfers out of tertiary units.
The 37 largest high risk perinatal centres in the United Kingdom.
One obstetric specialist and one neonatal specialist in each centre.
Suboptimal care resulting directly from pressure on service-that is, transfers out of tertiary units (either in utero or after delivery) because the unit was "full" and not because the hospital was incapable of providing the care needed.
All units provided data. The number of intensive care cots in each unit was between five and 16. During the three months 309 transfers occurred (equivalent to 1236 per year), of which 264 were in utero and 45 postnatal. Sixty five in utero transfers involved multiple births, hence the census related to 382 babies (1528 per year). There was considerable regional variation. The reason for transfer in most cases was "lack of neonatal beds".
Currently most major perinatal centres in the United Kingdom are regularly unable to meet in-house demand; this has implications for the service as a whole. The NHS has set no standards to help health authorities and primary care groups develop services relating to this specialty; such a step may well be an appropriate lever for change.
确定新生儿重症监护床位的可获得性在英国的任何地区或所有地区是否是一个问题。
1999年4月1日至6月30日为期三个月的普查，包括关于从三级医疗机构转出的简单数据表。
英国37家最大的高危围产期中心。
每个中心的一名产科专家和一名新生儿专家。
因服务压力直接导致的护理不足，即因单位“满员”而非医院无法提供所需护理而从三级医疗机构转出（宫内或分娩后）。
所有单位都提供了数据。每个单位的重症监护床位数量在5至16张之间。在这三个月期间，发生了309次转出（相当于每年1236次），其中264次是宫内转出，45次是产后转出。65次宫内转出涉及多胞胎，因此普查涉及382名婴儿（每年1528名）。存在相当大的地区差异。大多数情况下转出的原因是“缺乏新生儿床位”。
目前英国大多数主要的围产期中心经常无法满足内部需求；这对整个服务产生影响。国民保健制度没有设定标准来帮助卫生当局和初级保健团体发展与该专业相关的服务；这样的举措很可能是推动变革的合适手段。
