J Korean Med Sci.  2018 Feb;33(6):e43. 10.3346/jkms.2018.33.e43.

Improved Regional Disparities in Neonatal Care by Government-led Policies in Korea

Affiliations
  • 1Department of Pediatrics, Kyung Hee University Medical Center, Seoul, Korea.
  • 2Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. revival421@snu.ac.kr

Abstract

BACKGROUND
Although the number of high-risk neonates has increased in Korea, hospitals were reluctant to open or maintain neonatal intensive care unit (NICU) due to the low medical cost. Consequently, there were regional disparities in facilities, equipment, and neonatal health outcomes. For these reasons, the Korean government began to invest in neonatal care during the last decade. We identified the status of NICUs in Korea and assessed changes after the government-driven policies.
METHODS
We surveyed 87 of 89 hospitals that operated NICUs in 2015. The questionnaire assessed the number of NICU beds, admission and mortality rates of very low birthweight infants (VLBWIs), personnel status, equipment and facilities, and available multidisciplinary approach. Current data was compared with the previous studies and changes in the status and function of the nationwide NICU from 2009 and 2011.
RESULTS
During the last 7 years, there was an increase of 462 NICU beds, which met the required number estimated by the number of births and covered about 90% of regional VLBWI births. Status of facilities and equipment improved in all regions in Korea but there were still regional differences in multidisciplinary approach and human resources. The difference in odds ratios for mortality of VLBWI between regions decreased compared to 2009.
CONCLUSION
There was improvement in regional disparities of neonatal care and mortality of premature babies with the government investment in Korea. Further supports are required for human resources and referral system.

Keyword

Newborn; Policy; Korea

MeSH Terms

Humans
Infant
Infant Health
Infant, Newborn
Intensive Care, Neonatal
Investments
Korea*
Mortality
Odds Ratio
Parturition
Referral and Consultation
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