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The Impact of Neonatal Care Resources on Regional Variation in Neonatal Mortality Among Very Low Birthweight Infnats in Korea

Authors
 Jae Won Shim  ;  Myo Jing Kim  ;  Ee-Kyung Kim  ;  Hyun Kyung Park  ;  Eun Song Song  ;  Soon Min Lee  ;  Jang Hoon Lee  ;  Hyun-Seung Jin  ;  Eun Sun Kim  ;  Yun Sil Chang 
Citation
 PAEDIATRIC AND PERINATAL EPIDEMIOLOGY, Vol.27(2) : 216-225, 2013 
Journal Title
PAEDIATRIC AND PERINATAL EPIDEMIOLOGY
ISSN
 0269-5022 
Issue Date
2013
MeSH
Birth Rate ; Female ; Health Resources/economics* ; Health Resources/statistics & numerical data ; Hospitals ; Humans ; Infant Mortality* ; Infant, Newborn ; Infant, Very Low Birth Weight ; Intensive Care Units, Neonatal/economics* ; Intensive Care Units, Neonatal/statistics & numerical data ; Male ; Republic of Korea
Keywords
neonatology ; international child health ; neonatal mortality ; neonatal intensive care ; level of care
Abstract
BACKGROUND:
Faced with extremely low fertility rates and increasing numbers of low-birthweight births in Korea, we examined the factors affecting the mortality of very-low-birthweight (VLBW) infants in Korea.
METHODS:
A survey was conducted in 91 of 93 hospitals providing neonatal intensive care in Korea in 2009. Data included information on number of neonatal intensive care unit (NICU) beds, medical workforce, resources in the NICU, birth and death.
RESULTS:
There was approximately one NICU per 4888 births, one NICU bed per 355 births, one mechanical ventilator per 739 births, one incubator per 327 births and one board-certified neonatologist per 4683 births. Regional disparity existed in neonatal care resources and consequently in mortality rates. VLBW infants' mortality was related to the NICU facility level, volume of VLBW infants and geographic regions. The capital city, Seoul, has the best NICU facilities and workforce, and the least mortality. Overall mortality rates before hospital discharge for <750, 750-999 and 1000-1499 g were 44.8%, 20.4% and 6.5% respectively. There was a two to threefold difference in the mortality rates across the regions. However, following adjustments for NICU facility level and volume of VLBW infants admissions, regional difference in mortality rates was markedly reduced in the <750 g and disappeared in the larger VLBW groups.
CONCLUSIONS:
Regional disparity in mortality of VLBW infants in Korea is most marked in the lowest-birthweight group, <750 g. This disparity is primarily due to lack of resources for neonatal intensive care in most of provincial areas.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/ppe.12033/abstract
DOI
10.1111/ppe.12033
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Soon Min(이순민) ORCID logo https://orcid.org/0000-0003-0174-1065
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89030
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