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Published on: December 31, 2015
Perinatal health services organization for preterm births: a multinational comparison
L E Kelly1, P S Shah1,2, S Håkansson3
1Maternal-Infant Care Research Centre, Mount Sinai Hospital, 700 University Avenue, Toronto, ON, Canada.
Summary
Comparing healthcare for very preterm infants across 11 countries reveals similar outcomes but varied data collection. Evaluating population coverage, services, and metadata is crucial for accurate international comparisons of neonatal care.
Area of Science:
- Neonatalogy
- Public Health
- Comparative Healthcare Systems
Background:
- International Network for Evaluating Outcomes of Neonates (iNeo) collects data on neonates born before 32 weeks' gestation.
- Understanding variations in healthcare services and data comparability is essential for high-income countries.
Purpose of the Study:
- To examine population characteristics, health service organization, and data comparability for very low birth weight or very preterm neonates.
- To assess the landscape of neonatal care in 11 high-income countries contributing to iNeo.
Main Methods:
- Gathered population characteristics from public sources.
- Surveyed maternal and neonatal health service organization.
- Evaluated data comparability from participating countries (Australia, Canada, Finland, Israel, Italy, Japan, New Zealand, Spain, Sweden, Switzerland, UK).
Main Results:
- Nationally funded healthcare and high prenatal care coverage (>90%) were common.
- Preterm birth rates, maternal age, and mortality rates showed similarity across countries.
- Most transports utilized specialized teams, with physician presence mandated in many.
- Significant variation existed in 'step-down' unit capacity, particularly for respiratory care.
- Heterogeneity in data collection for benchmarking and quality improvement was identified.
Conclusions:
- International comparability of healthcare outcomes for very preterm neonates necessitates a thorough evaluation.
- Key factors for comparison include population coverage, healthcare service organization, and metadata consistency.
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