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Specialty newborn care: trends and issues
R M Schwartz1, R Kellogg, J H Muri
1National Perinatal Information Center, 144 Wayland Avenue, Suite 300, Providence, RI 02906, USA.
Summary
Neonatal special care services have expanded nationwide, but significant variations in physician staffing exist, even in intensive care units. This highlights a need for more standardized care for high-risk newborns.
Area of Science:
- Neonatal care
- Healthcare services research
- Pediatric critical care
Background:
- Availability of neonatal special care services in the US.
- Examining variations in staffing and service provision.
Purpose of the Study:
- To explore the availability of neonatal special care services across the US.
- To examine variations in these services from staffing and service perspectives.
Main Methods:
- Utilized American Hospital Association survey data.
- Conducted a special national survey of hospitals with special care services (69% response rate).
- Analyzed changes in high-risk care status between 1983 and 1997.
Main Results:
- Neonatal special care supply has expanded across all US regions.
- Significant variation in medical staffing observed, even in intensive care units.
- 25% of hospitals lacked 24-hour in-house physician coverage.
Conclusions:
- Widespread availability of high-risk newborn care suggests a potential oversupply.
- Differential physician staffing raises concerns about the need for standardized neonatal care.