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Spanish survey on follow-up programmes for children born very preterm
Carmen Rosa Pallás-Alonso1, Begoña Loureiro2, Javier De la Cruz Bértolo1
1Division of Neonatology, Health Research Institute i + 12, University Hospital 12 de Octubre, Universidad Complutense, Madrid, Spain.
Insights
Follow-up care for very preterm or very low birth weight infants in Spain is inconsistent. Many hospitals lack routine assessments and training for pediatric residents, impacting equitable care for this high-risk group.
Area of Science:
- Neonatal care
- Pediatric follow-up programs
- Public health systems
Background:
- Children born very preterm (less than 32 weeks gestation) or with very low birth weight (less than 1,500 g) require specialized, long-term follow-up.
- Variations in healthcare practices can lead to disparities in developmental outcomes for these vulnerable children.
Purpose of the Study:
- To describe the variations in follow-up program practices for very preterm or very low birth weight children in Spain.
- To assess the current state of follow-up care organization, resources, and specific assessments within the Spanish National Health Service.
Main Methods:
- A national survey was electronically distributed to level II and III hospital units in the Spanish National Health Service in 2016.
- The survey comprised 70 questions covering follow-up organization, resources, routine assessments, inter-service collaboration, family engagement, data management, and training.
Main Results:
- A high response rate of 91.5% (141/154) was achieved.
- While 70.9% of units provide follow-up, only 42% extend it up to six years.
- Significant gaps exist in routine neurological (60% lacking), ophthalmological (37% lacking) assessments, and second hearing assessments (62% lacking).
- Only 38% of units have a psychologist, and 41% of hospitals do not include follow-up skills training in their pediatric residency programs.
Conclusions:
- Despite Spain's universal healthcare system, follow-up care for very preterm/very low birth weight children is inequitable.
- A substantial proportion of pediatric residents (nearly half) do not receive adequate training in managing this high-risk population.
- There is a critical need to standardize and improve follow-up programs to ensure equitable developmental support for these children.
Aim:
To describe variations in practice between follow-up programmes for very preterm children born at less than 32 weeks' gestation or with very low birth weight of less than 1,500 g.
Methods:
A survey on follow-up practices was electronically distributed to level II and III units among hospitals of the Spanish National Health Service in 2016. The survey included 70 questions covering issues such as follow-up organisation and resources, routine assessments, relationships with other services and families, information management and training.
Results:
The response rate was 91.5% (141/154). Among respondents, 70.9% (100/141) reported that they do provide follow-up and 42% do so up to six years of age. Routine neurological and ophthalmological follow-up is not performed in 60% and 37% of hospitals, respectively, and a second hearing assessment is not given in 62%. Just 38% of units have psychologist. In 41% of hospitals, training in follow-up skills is not included in Paediatric Residency training programme.
Conclusion:
Although Spain has a nationwide health system that provides universal health coverage, we found that follow-up care for children born very preterm/very low birth weight is not equitable. Nearly half of paediatric residents receive no training in follow-up for this high-risk population.
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