Evaluation of a one-year Swedish neonatal care population.

A one-year population of 527 newborn infants treated in a Swedish neonatal unit was studied with regard to the effectiveness of the neonatal care in rate of normal survival and rate of handicaps at 3 years of age. The effectiveness could be accurately calculated in terms of survival rate being 84% and 98% of outborns and inborns respectively, and in terms of survivors without neurodevelopmental handicaps at 3 years of age being 90% and 97%, respectively. From available data on the cost of the neonatal care it could be estimated that the average annual costs for rehabilitation care for a light or moderately to a severely handicapped child were 5.8 to 11.2 times higher than in average per patient in-hospital costs during neonatal treatment. It is evident that skills in specialized neonatal care are indispensable for optimal outcome for very small low birthweight infants below 1500 g or born before 30(-32) weeks of gestation. However, in order to evaluate the return on expenditure for prevention of handicaps from the viewpoint of society adequate data on effectiveness of treatment as well as economic cost-efficiency are necessary for local and regional organization of neonatal care units.