[Economy and effectiveness of a neonatal emergency service on a regional basis]

A prospective study was conducted with the aim of assessing the effectiveness of a clinic's own EMSN. To this end, the relationship between morbidity, mortality, and place of birth among 236 newborns with birthweights under 1500 grams was investigated. In addition, the time spent on ambulance trips was determined, as were the rates of attendance of pediatricians at births. A comparison of treatment practice and results among infants transferred "internally" from the neighboring gynecologic clinic with those achieved in newborns transferred from outside showed that the effectiveness of the EMSN was limited and was "bought" at great expense. In particular among children with birthweights of 1000 g and more, referrals from outside included significantly more cases of surfactant deficiency syndrome and intraventricular hemorrhage, and the mortality rate among them was higher. The study underscores the need for, and confirms the possibility of, timely "internal" transfer of high-risk children to a perinatal center.