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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Evaluation of neonatal intensive care for extremely-low-birth-weight infants
1Department of Obstetrics and Gynaecology, The Royal Women's Hospital, 132 Grattan St, Carlton, Victoria 3053, and University of Melbourne, Melbourne, Australia. lwd@unimelb.edu.au
Insights
Neonatal intensive care for extremely-low-birth-weight (ELBW) infants has become more effective and available in Victoria, Australia. Ongoing evaluation is recommended to maintain these improvements in infant survival and care quality.
Area of Science:
- Neonatalogy
- Public Health
- Health Services Research
Background:
- Neonatal intensive care for extremely-low-birth-weight (ELBW) infants requires ongoing evaluation for effectiveness, efficiency, and availability.
- Historical data from Victoria, Australia, provides a basis for assessing trends in ELBW infant care.
Purpose of the Study:
- To evaluate the effectiveness, efficiency, and availability of neonatal intensive care for ELBW infants in Victoria, Australia, from the late 1970s to the late 1990s.
- To establish a baseline for future assessments of neonatal intensive care services.
Main Methods:
- Retrospective analysis of data on ELBW infants born in Victoria, Australia.
- Tracking survival rates (long-term and quality-adjusted) and healthcare access over a 20-year period.
Main Results:
- Significant increases in long-term survival rates for ELBW infants, from 25% to 73% between 1979-1980 and 1997.
- Substantial improvements in quality-adjusted survival rates, rising from 19% to 59% over the same period.
- Demonstrated high and stable efficiency of neonatal intensive care, favorable compared to other health programs, with increasing availability and access.
Conclusions:
- Neonatal intensive care for ELBW infants in Victoria has shown marked improvements in effectiveness and availability.
- The efficiency of these services has remained high and stable.
- Periodic re-evaluation is crucial to sustain the effectiveness, efficiency, and availability of neonatal intensive care for ELBW infants.
Abstract:
Neonatal intensive care for extremely-low-birth-weight (ELBW, 500-999 g) infants must be evaluated to determine that it is effective, efficient, and available to those who need it. From the late 1970s until the late 1990s in the state of Victoria, Australia, neonatal intensive care has been increasingly effective, with large increases in the long-term survival rate from 25% in 1979-1980 to 73% in 1997, and in the quality-adjusted survival rate from 19% to 59% over the same time. Its efficiency has been relatively high and stable over time, comparing favourably with many other health-care programmes. It is increasingly available, with fewer than 10% of ELBW infants born outside level III perinatal centres in the latest era, and proportionally more ELBW infants being offered intensive care over time. Neonatal intensive care should be re-evaluated at intervals in the future to ensure that its effectiveness, efficiency and availability are maintained.
