A nationwide survey on neonatal medical resources in mainland China: current status and future challenges
A nationwide survey on neonatal medical resources in mainland China: current status and future challenges
复制标题
中国大陆新生儿医疗资源调查：现状与未来挑战
DOI：
10.1186/s12887-019-1780-4
复制
发表时间：
2019-11-13
期刊：
影响因子：
2.4
通讯作者：
Feng, Zhichun
中科院分区：
文献类型：
--
作者：
Li, Qiuping;Han, Tao;Feng, Zhichun
研究背景近二十年来，随着经济的快速发展，医学在我国也得到了迅速的发展。然而，目前对中国新生儿科的确切发展状况知之甚少。为了解中国大陆新生儿护理资源的现状，对中国大陆新生儿护理机构的规模、设施、人员、技术、服务等方面进行了调查，新生儿科的转运系统和早产儿结局结果本次调查共发放问卷117份，调查结果显示，ND的平均患病率为65（中位数47;范围5-450）张床位，包括19.59张（中位数15，范围0-100）NICU床位。整体医生/床位和护士/床位比例分别为1：3.84和1：1.43。缺乏医疗设备是大多数被调查的新生儿护理机构的主要问题之一，只有26个（22.2%）新生儿护理机构每床有一个以上的新生儿保温箱。分别只有70.1%、30.6%、30.8%和4.3%的ND进行了高频通气、低温、一氧化氮吸入和ECMO。提供先进治疗的能力随着ND的大小而增加（P<0.01）。81例（69.2%）新生儿进行了转运，但仅有70例（86.4%）配备了转运保温箱，36例（44.4%）具备早产儿宫内转运能力，3例（3.7%）具备早产儿空运能力。2011年极早产儿（胎龄<28 w）出院存活率为47.8%。结论中国大陆新生儿出生地分布不均匀，仍面临人员短缺、设施不足、交通不完善等问题。建立新生儿护理分级制度，提高医疗资源利用率，改善危重儿预后是当务之急。
BackgroundWith the rapid development of economy in recent two decades, neonatology has been progressing quickly in China. However, there is little knowledge about the exact developmental status of neonatal departments in China. The aim of this study was to assess resources available for care of sick newborns in mainland China.MethodsQuestionnaires were sent to the membership of the Chinese Neonatologist Association (CNA) and used to survey the scale, facilities, staff, technologies, transport systems and preterm infants’ outcomes of neonatal departments (NDs) in different areas of China from June 2012 to December 2012.ResultsThe result of this survey including a total of 117 questionnaires showed that investigated ND had a mean of 65 (median 47; range 5–450) beds, including 19.59 (median 15, range 0–100) NICU beds. The overall doctor/bed and nurse/bed ratio was 1:3.84 and 1:1.43, respectively. Lack of medical equipment was one of the main problems in most NDs surveyed, and only 26 NDs (22.2%) had more than one neonatal incubator per bed. Only 70.1, 30.6, 30.8 and 4.3% NDs carried out high-frequency ventilation, hypothermia, nitric oxide inhalation, and ECMO respectively. The capacity to provide advanced therapies increased with the size of the NDs (P< .01). A total of 81 NDs (69.2%) carried out neonatal transport, but only 70 NDs (86.4%) were equipped with transport incubators, 36 NDs (44.4%) had the ability of performing intrauterine transport of the preterm infants, and 3 NDs (3.7%) had the ability of performing air transport. The survival rate of extremely preterm infants (Gestational age less than 28w) to discharge home was 47.8% in 2011.ConclusionNDs in mainland China are not well distributed and still face many problems, such as staff shortage, inadequate facilities, and imperfect transport. It is urgent to set up a classification of neonatal care to enhance the utilization rate of medical resources and improve the prognosis of critically ill infants.