Department of Pediatrics and Infant Neuropsychiatry, Neonatal Emergency Transport Service, Sapienza University of Rome, Rome, Italy.
Division of Neonatology and Neonatal Intensive Care Unit, ASL Roma 2 - Ospedale Sant'Eugenio, Rome, Italy.
Ital J Pediatr. 2019 Apr 18;45(1):51. doi: 10.1186/s13052-019-0640-z.
Despite regionalization of perinatal care provides for the "in utero" transfer of high-risk pregnancies, there will always be a number of neonates who undergo acute inter-facility transport. The presence of a well-organized Neonatal Emergency Transport Service (NETS) can prevent and reduce risks of transportation, especially for very preterm infants, and is therefore mandatory for any program of regionalization of perinatal care. Italian National Health System is highly decentralized and Regions are autonomous to structure, plan and delivery their regional health services. Consequently, organization models and resources available vary widely and significant regional differences in access and quality of health services have been reported in the past years. A national survey was conducted in 2015 by the neonatal transport study group of the Italian Society of Neonatology with the aim to describe neonatal transfer practices and to assess the Neonatal Emergency Transport Services (NETS) status in the 20 Italian regions.
A questionnaire regarding neonatal transfer practices and NETS activity for the previous year (2014) was sent to the 44 NETS operating in the 20 Italian regions. Demographic data were obtained from the Italian National Statistical Institute (ISTAT).
The overall survey response rate was 100%. In 2014, only 12 (60%) of the 20 Italian regions were fully covered by NETS, 3 (15%) regions were partially covered, while neonatal transport was not available in 5 (25%) regions. Overall, in 2014, the 44 NETS operating in Italy transported a total of 6387 infants, including 522 (8.17%) having a gestational age < 28 weeks.
The organization of NETS in Italy is devolved on a regional basis, resulting in a large heterogeneity of access and quality to services across the country. Where available, NETS are generally well-equipped and organized but limited volume of activities often cannot guarantee adequate levels of skills of personnel or an appropriate cost-efficiency ratio. The regions reported with lack of NETS have managed, or are trying, to fill the gap, but continuing efforts to reduce regional differences in the availability and quality of services are still needed.
尽管围产期护理的区域化提供了高危妊娠的“宫内”转移，但总会有一些新生儿需要进行急性院内转运。组织良好的新生儿紧急转运服务（NETS）的存在可以预防和降低转运风险，特别是对于极早产儿，因此对于任何围产期护理的区域化计划都是强制性的。意大利国家卫生系统高度分散，各地区在结构、规划和提供区域卫生服务方面具有自主权。因此，组织模式和可用资源差异很大，过去几年报告了在卫生服务的可及性和质量方面存在显著的地区差异。2015 年，意大利新生儿学会的新生儿转运研究小组进行了一项全国性调查，旨在描述新生儿转运实践，并评估 20 个意大利地区的新生儿紧急转运服务（NETS）状况。
向 20 个意大利地区的 44 个 NETS 发送了一份关于新生儿转运实践和 NETS 活动的问卷，这些活动是针对前一年（2014 年）进行的。人口统计数据来自意大利国家统计局（ISTAT）。
总体调查回复率为 100%。2014 年，只有 12 个（60%）意大利地区完全由 NETS 覆盖，3 个（15%）地区部分覆盖，而 5 个（25%）地区则没有新生儿转运服务。总体而言，2014 年，意大利 44 个 NETS 共转运了 6387 名婴儿，其中 522 名（8.17%）胎龄<28 周。
意大利 NETS 的组织基于地区，导致全国范围内服务的可及性和质量存在很大差异。在有 NETS 的地方，它们通常设备齐全、组织良好，但活动量有限往往不能保证人员的适当技能水平或适当的成本效益比。报告缺乏 NETS 的地区已经或正在努力填补这一空白，但仍需要继续努力减少服务的可用性和质量方面的地区差异。
