Neonatal Med.  2020 May;27(2):65-72. 10.5385/nm.2020.27.2.65.

Current Status of Neonatologist Staffing and Workload in Korean Neonatal Intensive Care Units

• Lee BS
• Lim JW
• Choi YS
• Kim KS

• KMID: 2503161
• DOI: http://doi.org/10.5385/nm.2020.27.2.65

Abstract

Purpose
To identify the recent status of the neonatologist and their workload in neonatal intensive care unit (NICU) in Korea.
Methods
On October 2018, a survey was conducted on the statistics of the workforce including the census of certified neonatologists, NICU beds, nursing staffing ratings, bed occupancy rate, annual admission of very low birth weight infant (VLBWI), infant acuity score of nursing, and the proportion of out-born patients. The level of neonatal care was self-rated.
Results
A total of 68 centers responded to the survey. An average number of cer tified neonatologists and the number of NICU beds per center was 1.9 (range, 0 to 5) and 23.1 (range, 0 to 30), respectively. Thirty-eight percent (n=26) of NICUs were being operated with only one (n=24) or no (n=2) certified neonatologist and only 19% (n=13) of NICUs had ≥3 neonatologists. The average ratio of NICU beds to neonatologists rated 13.4±6.2. The higher the level of neonatal care, the higher the number of tertiary referral hospitals, neonatologists, NICU volume, infant acuity scores of nursing, and annual VLBWI admissions. However, there was no difference in the beds to neonatologist ratio between level 2 (n=9, 9.5±3.1), level 3 (n=44, 14.0± 6.9), and level 4 (n=14, 13.7±4.2). The infant acuity score was proportional to the NICU volumes, but not related to the beds to neonatologist ratio.
Conclusion
Compared with the international standards, most Korean NICUs were understaffed in terms of the certified neonatologist and were unable to provide ‘continuity of care’ for high-risk newborns.

Keyword

Intensive care, neonatal; Workforce; Level of neonatal care

Figure

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  Figure 1. Number of neonatal intensive care unit (NICU) beds per neonatologist in 68 Korean centers in 2018.

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  Figure 2. Change in neonatal intensive care unit (NICU) bed occupancy rate from 2017 to 2018 in Korea.

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  Figure 3. Comparison of parameters of workforce and operation status between the three levels of neonatal care in Korean neonatal intensive care units (NICUs). (A) Level of hospital, (B) nurse staffing grade, (C) number of NICU beds per neonatologist, (D) bed occupancy rate, (E) annual number of very low birth weight infant (VLBWI) admission, and (F) percentage of outborn patients.

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