Paul David A, Pearlman Stephen A
Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
Department of Pediatrics, ChristianaCare, Newark, DE, USA.
J Perinatol. 2024 Oct 1. doi: 10.1038/s41372-024-02129-5.
Utilization of the Neonatal Intensive Care Unit (NICU) varies widely in the United States. Over recent decades, there has been a growth in NICUs, that varies by region, and has not been correlated to changes in demand or illness severity. Unnecessary NICU admissions are costly, stressful to families, may increase the risk of hospital acquired morbidities, and decrease breast feeding. Most of the variation in NICU utilization is based on the care of late preterm, early term, and term babies and is related to hospital level factors, including financial incentives, driving utilization. Improvement strategies to reduce variation include regionalization of care, certificate of need legislation, improving discharge processes, and caring for babies with some conditions such as Neonatal Opioid Withdrawal Syndrome or those with risk factors for sepsis outside of the NICU.
在美国，新生儿重症监护病房（NICU）的使用情况差异很大。在最近几十年里，NICU的数量有所增加，且因地区而异，与需求或疾病严重程度的变化并无关联。不必要的NICU收治成本高昂，给家庭带来压力，可能会增加医院获得性疾病的风险，并减少母乳喂养。NICU使用情况的大部分差异是基于晚期早产儿、早期足月儿和足月儿的护理，并且与医院层面的因素有关，包括推动使用的经济激励措施。减少差异的改进策略包括医疗区域化、需求证书立法、改进出院流程，以及在NICU之外护理患有某些疾病（如新生儿阿片类药物戒断综合征）或有败血症风险因素的婴儿。
