远程医疗合作改善了围产期区域化，并降低了全州的婴儿死亡率。
Telemedicine collaboration improves perinatal regionalization and lowers statewide infant mortality.
机构信息
Department of Pediatrics/Neonatology, College of Medicine, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, AR, USA.
出版信息
J Perinatol. 2013 Sep;33(9):725-30. doi: 10.1038/jp.2013.37. Epub 2013 Apr 11.
OBJECTIVE
We assessed a telemedicine (TM) network's effects on decreasing deliveries of very low birth weight (VLBW, <1500 g) neonates in hospitals without Neonatal Intensive Care Units (NICUs) and statewide infant mortality.
STUDY DESIGN
This prospective study used obstetrical and neonatal interventions through TM consults, education and census rounds with 9 hospitals from 1 July 2009 to 31 March 2010. Using a generalized linear model, Medicaid data compared VLBW birth sites, mortality and morbidity before and after TM use. Arkansas Health Department data and χ(2) analysis were used to compare infant mortality.
RESULT
Deliveries of VLBW neonates in targeted hospitals decreased from 13.1 to 7.0% (P=0.0099); deliveries of VLBW neonates in remaining hospitals were unchanged. Mortality decreased in targeted hospitals (13.0% before TM and 6.7% after TM). Statewide infant mortality decreased from 8.5 to 7.0 per 1000 deliveries (P=0.043).
CONCLUSION
TM decreased deliveries of VLBW neonates in hospitals without NICUs and was associated with decreased statewide infant mortality.
目的
评估远程医疗（TM）网络对减少无新生儿重症监护病房（NICU）医院极低出生体重（VLBW，<1500g）新生儿分娩数量和全州婴儿死亡率的影响。
研究设计
这项前瞻性研究使用 TM 咨询、教育和人口普查轮次中的产科和新生儿干预措施，涉及 2009 年 7 月 1 日至 2010 年 3 月 31 日期间的 9 家医院。使用广义线性模型，根据医疗补助数据比较 TM 使用前后 VLBW 出生地点、死亡率和发病率。阿肯色州卫生部数据和 χ(2)分析用于比较婴儿死亡率。
结果
目标医院的 VLBW 新生儿分娩量从 13.1%降至 7.0%（P=0.0099）；其余医院的 VLBW 新生儿分娩量保持不变。目标医院的死亡率下降（TM 前为 13.0%，TM 后为 6.7%）。全州婴儿死亡率从每 1000 例分娩 8.5 例降至 7.0 例（P=0.043）。
结论
TM 减少了无 NICU 医院的 VLBW 新生儿分娩数量，并与全州婴儿死亡率降低相关。
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