Functional Analysis of Neonatal Intensive Care Centers and Effective Operation Plan.

Kim,  Eun Sun; Shin,  Seung Han; Kim,  Han Suk

doi:2013.20.2.179

Neonatal Med > Volume 20(2); 2013 > Article

Review

Neonatal Medicine 2013;20(2):179-188.
DOI: https://doi.org/10.5385/nm.2013.20.2.179 Published online June 26, 2013.

Functional Analysis of Neonatal Intensive Care Centers and Effective Operation Plan.

Eun Sun Kim, Seung Han Shin, Han Suk Kim

¹Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea.
²Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. kimhans@snu.ac.kr

Abstract

Regional hub neonatal intensive care centers are opening supported by Ministry of Health and Welfare, with the need for more neonatal intensive care unit (NICU) beds response to increasing number of prematurity. Besides beds expansion, functional role of NICU is important and the evaluation tool of functional analysis of NICU is necessary. In this review, admission of preterm infant born before 32 gestational weeks was considered as a functional component and the annual number of those babies was used as an activity marker. The activity of NICU was higher with increased bed number, but also increased equipment, NICU personnel, obstetric personnel were independent factors for the higher NICU activity. Levels of NICU can be defined according to the activity, and reference bed size, equipment, personnel can be defined according to each level. In reverse, functional analysis of NICU can be performed with known bed size or equipment predicting activity level. Meanwhile, the evaluation of 13 regional hub NICU revealed that they partially contributed to the regionalization of NICU, and the activity was increased in all regional hub NICUs. Three regional hub NICUs showed markedly increased activity after opening, and those centers showed increased NICU personnel and obstetric personnel compared to other centers. In terms of regional hub government support, multilateral plan should be operated, besides simple bed size, considering distribution of different functional level of regional NICUs and leaking patient in the region.

Key Words: Neonatal intensive care unit level; Preterm infant; Patient volume; Regionalization