Female ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Interrupted Time Series Analysis ; Pregnancy ; Premature Birth* / epidemiology ; Premature Birth* / prevention & control ; Republic of Korea / epidemiology
Keywords
health policy ; high‐risk birth ; interrupted time series ; low‐birth‐weight delivery ; maternal‐fetal intensive care unit ; preterm birth
Abstract
Objective: To investigate the impact of the introduction of Integrated Maternal-Fetal Intensive Care Unit (MFICU) reimbursement rates for high-risk newborns in South Korea.
Method: The present study used data from the Population Dynamics data released annually by Statistics Korea, which contain information on all births in the country from October 1, 2015, to September 31, 2019. The MFICU reimbursement fee began on October 1, 2017, and the follow-up period was 24 months before and after the intervention. The dependent variable was defined as either premature births (before 37 weeks of pregnancy) or underweight births (birth weight ≤2.5 kg). A total of 1 377 841 infants were included in the present study, and an Interrupted Time Series with segmented regression analysis was performed.
Results: After the intervention, the premature or low-birth-weight deliveries decreased by approximately 0.4%. The difference in the level change was more significant in legitimate children and multiple births. Premature neonates showed a significantly different level of change compared with low-birth-weight neonates.
Conclusion: The expansion of the MFICU reduces high-risk births, such as premature births and those involving low birth weight. To effectively care for high-risk deliveries, the enhancement of obstetric care and continuous medical support policies must be maintained.