Division of Neonatology, Health Research Institute i + 12, University Hospital 12 de Octubre, Universidad Complutense, Madrid, Spain.
Division of Neonatology, University Hospital Cruces, Barakaldo, Spain.
Acta Paediatr. 2019 Jun;108(6):1042-1048. doi: 10.1111/apa.14647. Epub 2018 Dec 14.
To describe variations in practice between follow-up programmes for very preterm children born at less than 32 weeks' gestation or with very low birth weight of less than 1,500 g.
A survey on follow-up practices was electronically distributed to level II and III units among hospitals of the Spanish National Health Service in 2016. The survey included 70 questions covering issues such as follow-up organisation and resources, routine assessments, relationships with other services and families, information management and training.
The response rate was 91.5% (141/154). Among respondents, 70.9% (100/141) reported that they do provide follow-up and 42% do so up to six years of age. Routine neurological and ophthalmological follow-up is not performed in 60% and 37% of hospitals, respectively, and a second hearing assessment is not given in 62%. Just 38% of units have psychologist. In 41% of hospitals, training in follow-up skills is not included in Paediatric Residency training programme.
Although Spain has a nationwide health system that provides universal health coverage, we found that follow-up care for children born very preterm/very low birth weight is not equitable. Nearly half of paediatric residents receive no training in follow-up for this high-risk population.
描述小于 32 孕周或出生体重小于 1500 克的极早产儿随访方案之间的实践差异。
2016 年，对西班牙国家卫生服务体系中的二级和三级医院的随访实践进行了一项调查。该调查包括 70 个问题，涵盖了随访组织和资源、常规评估、与其他服务和家庭的关系、信息管理和培训等问题。
应答率为 91.5%（141/154）。在应答者中，70.9%（100/141）报告他们确实提供了随访，42%的随访持续到 6 岁。分别有 60%和 37%的医院未进行常规神经和眼科随访，62%的医院未进行第二次听力评估。只有 38%的单位有心理学家。在 41%的医院，儿科住院医师培训计划中不包括随访技能培训。
尽管西班牙拥有一个提供全民健康覆盖的全国性卫生系统，但我们发现，对极低出生体重/极低出生体重儿的随访护理并不公平。近一半的儿科住院医师没有接受过针对这一高危人群的随访培训。
