Department of Pediatrics, Kyung Hee University Medical Center, Seoul, Korea.
Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2018 Feb 5;33(6):e43. doi: 10.3346/jkms.2018.33.e43.
Although the number of high-risk neonates has increased in Korea, hospitals were reluctant to open or maintain neonatal intensive care unit (NICU) due to the low medical cost. Consequently, there were regional disparities in facilities, equipment, and neonatal health outcomes. For these reasons, the Korean government began to invest in neonatal care during the last decade. We identified the status of NICUs in Korea and assessed changes after the government-driven policies.
We surveyed 87 of 89 hospitals that operated NICUs in 2015. The questionnaire assessed the number of NICU beds, admission and mortality rates of very low birthweight infants (VLBWIs), personnel status, equipment and facilities, and available multidisciplinary approach. Current data was compared with the previous studies and changes in the status and function of the nationwide NICU from 2009 and 2011.
During the last 7 years, there was an increase of 462 NICU beds, which met the required number estimated by the number of births and covered about 90% of regional VLBWI births. Status of facilities and equipment improved in all regions in Korea but there were still regional differences in multidisciplinary approach and human resources. The difference in odds ratios for mortality of VLBWI between regions decreased compared to 2009.
There was improvement in regional disparities of neonatal care and mortality of premature babies with the government investment in Korea. Further supports are required for human resources and referral system.
尽管韩国的高危新生儿数量有所增加，但由于医疗费用低，医院不愿意开设或维持新生儿重症监护病房（NICU）。因此，在设施、设备和新生儿健康结果方面存在地区差异。出于这些原因，韩国政府在过去十年开始投资新生儿护理。我们确定了韩国 NICU 的现状，并评估了政府推动政策后的变化。
我们调查了 2015 年运营 NICU 的 89 家医院中的 87 家。问卷评估了 NICU 床位数量、极低出生体重儿（VLBWI）的入院率和死亡率、人员状况、设备和设施以及可用的多学科方法。将当前数据与之前的研究以及 2009 年和 2011 年全国 NICU 的状况和功能变化进行了比较。
在过去的 7 年中，NICU 床位增加了 462 张，这满足了根据出生人数估计的所需数量，并覆盖了约 90%的地区 VLBWI 出生人数。韩国所有地区的设施和设备状况都有所改善，但多学科方法和人力资源方面仍存在地区差异。与 2009 年相比，地区间 VLBWI 死亡率的优势比差异有所缩小。
随着韩国政府对新生儿护理的投资，地区间新生儿护理和早产儿死亡率的差异有所改善。还需要对人力资源和转诊系统提供进一步的支持。
