Handley Sara C, Lorch Scott A
Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, PA, United States.
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
J Perinatol. 2022 Jun;42(6):835-838. doi: 10.1038/s41372-022-01404-7. Epub 2022 Apr 23.
The goal of regionalization of neonatal care is to improve infant outcomes by directing patients to hospitals where risk-appropriate care is available. Although evidence shows that regionalized, risk-appropriate neonatal care decreases mortality, especially for high-risk infants, the approach and success of regionalization efforts in the U.S. and around the world is highly variable. Barriers to regionalization exist on the patient, provider, hospital, state, and national levels, which highlight potential opportunities to improve regionalization efforts. Improving neonatal regionalized care delivery requires a collaborative approach inclusive of all stakeholders from patients to national professional organizations, expansion and adaptation of current policies, changes to financial incentives, cross-state collaboration, support of national policies, and partnership between neonatal and obstetric communities to promote comprehensive, regionalized perinatal care.
新生儿护理区域化的目标是通过将患者引导至能够提供风险适配性护理的医院,来改善婴儿的预后。尽管有证据表明,区域化、风险适配性的新生儿护理可降低死亡率,尤其是对高危婴儿而言,但美国及全球范围内区域化工作的方法和成效差异很大。区域化在患者、医护人员、医院、州和国家层面均存在障碍,这凸显了改善区域化工作的潜在机会。改善新生儿区域化护理服务需要一种协作方法,涵盖从患者到国家专业组织的所有利益相关者,扩大并调整现行政策,改变经济激励措施,开展跨州合作,支持国家政策,以及新生儿和产科群体之间建立伙伴关系,以促进全面的、区域化的围产期护理。