Nationwide survey of neonatal transportation practices in Italy

被引:13
|
作者
Gente, Maurizio [1 ,15 ]
Aufieri, Roberto [2 ]
Agostino, Rocco [3 ]
Fedeli, Tiziana [4 ]
Calevo, Maria Grazia [5 ]
Massirio, Paolo [6 ]
Bellini, Carlo [6 ,17 ]
Schettini, S. [7 ]
Raimondi, F. [8 ]
Carpentieri, M. [9 ]
Panico, M. [10 ]
Demarini, S. [11 ]
Cattarossi, L. [12 ]
Ferrari, F. [13 ]
Gargano, G. [14 ]
Dotta, A. [16 ]
Mosca, F. [18 ]
Martinelli, S. [19 ]
Villani, E. P. [20 ]
Bernardo, L. [21 ]
Tagliabue, P. [22 ]
Stronati, M. [23 ]
Barbarini, M. [24 ]
Bellu, R. [25 ]
Agosti, M. [26 ]
Chirico, G. [27 ]
Mangili, G. [28 ]
Flumini, C. [29 ]
Santillo, V. [30 ]
Ferrero, F. [31 ]
Farina, D. [32 ]
Vivalda, M. [32 ]
Bertino, E. [32 ]
Guala, G. [33 ]
Marra, A. [34 ]
Gancia, P. [35 ]
Gazzolo, D. [36 ]
Magaldi, R. [37 ]
Gatta, A. [38 ]
Bisceglia, M. [38 ]
Tumminelli, F. [39 ]
Barbieri, I. [40 ]
Arco, A. [40 ]
Sulliotti, G. [41 ]
Cacace, C. [42 ]
Moroni, M. [43 ]
Tomassini, B. [44 ]
Boldrini, A. [45 ]
Biver, P. [45 ]
Messner, H. [46 ]
机构
[1] Sapienza Univ Rome, Dept Pediat & Infant Neuropsychiat, Neonatal Emergency Transport Serv, Rome, Italy
[2] ASL Roma 2 Osped St Eugenio, Div Neonatol & Neonatal Intens Care Unit, Rome, Italy
[3] Villa Margherita Private Nursing Home, Div Neonatol, Rome, Italy
[4] Fdn MBBM, Neonatal Intens Care Unit, Monza, Italy
[5] IRCCS Ist Giannina Gaslini, Dept Epidemiol Biostat & Committees, Genoa, Italy
[6] IRCCS Ist Giannina Gaslini, Dept Mother & Child, Neonatal Intens Care Unit, Neonatal Emergency Transport Serv, Largo G Gaslini 5, I-16147 Genoa, Italy
[7] Hosp San Carlo, Potenza, Italy
[8] Hosp Federico II, Naples, Italy
[9] Hosp Santobono, Naples, Italy
[10] Hosp San Sebastiano, Caserta, Italy
[11] Hosp Burlo Garofalo, Trieste, Italy
[12] Hosp Santa Maria della Misericordia, Udine, Italy
[13] Hosp Modena, Modena, Italy
[14] Hosp Santa Maria Nuova, Reggio Emilia, Italy
[15] Policlin Umberto 1, Rome, Italy
[16] Hosp Bambino Gesu, Rome, Italy
[17] Gaslini Inst, Genoa, Italy
[18] Hosp Ca Granda Policlin, Milan, Italy
[19] Hosp Niguarda, Milan, Italy
[20] Hosp Carlo Poma, Mantua, Italy
[21] Hosp Macedonio Melloni, Milan, Italy
[22] Hosp San Gerarado, Monza, Italy
[23] Policlin San Matteo, Pavia, Italy
[24] Hosp St Anna, Como, Italy
[25] Hosp Lecco, Lecce, Italy
[26] Hosp Varese, Varese, Italy
[27] Spedali Civili Brescia, Brescia, Italy
[28] Hosp Papa Giovanni XXIII, Bergamo, Italy
[29] Hosp Riuniti Ancona, Ancona, Italy
[30] Hosp Cardarelli, Campobasso, Italy
[31] Hosp Maggiore della Carita, Novara, Italy
[32] Hosp St Anna, Turin, Italy
[33] Hosp Maria Vittoria, Turin, Italy
[34] Hosp Moncalieri, Turin, Italy
[35] Hosp Croce & Carle, Cuneo, Italy
[36] Hosp Arrigo, Alessandria, Italy
[37] Hosp Riuniti Foggia, Foggia, Italy
[38] Hosp Casa Sollievo & Sofferenza, Foggia, Italy
[39] ASL4, Enna, Italy
[40] Hosp Martino, Messina, Italy
[41] Hosp Cervello, Palermo, Italy
[42] Hosp Barone Romeo, Messina, Italy
[43] Hosp Meyer, Florence, Italy
[44] Hosp Santa Maria alle Scotte, Siena, Italy
[45] Hosp Pisa, Pisa, Italy
[46] Hosp Bolzano, Bolzano, Italy
[47] Hosp Padova, Padua, Italy
[48] Policlin Rossi, Verona, Italy
关键词
Infant; newborn; Intensive care; neonatal transport; Perinatal care; Regional medical programs; Health services accessibility; PERINATAL-CARE;
D O I
10.1186/s13052-019-0640-z
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
BackgroundDespite regionalization of perinatal care provides for the in utero transfer of high-risk pregnancies, there will always be a number of neonates who undergo acute inter-facility transport. The presence of a well-organized Neonatal Emergency Transport Service (NETS) can prevent and reduce risks of transportation, especially for very preterm infants, and is therefore mandatory for any program of regionalization of perinatal care. Italian National Health System is highly decentralized and Regions are autonomous to structure, plan and delivery their regional health services. Consequently, organization models and resources available vary widely and significant regional differences in access and quality of health services have been reported in the past years. A national survey was conducted in 2015 by the neonatal transport study group of the Italian Society of Neonatology with the aim to describe neonatal transfer practices and to assess the Neonatal Emergency Transport Services (NETS) status in the 20 Italian regions.MethodsA questionnaire regarding neonatal transfer practices and NETS activity for the previous year (2014) was sent to the 44 NETS operating in the 20 Italian regions. Demographic data were obtained from the Italian National Statistical Institute (ISTAT).ResultsThe overall survey response rate was 100%. In 2014, only 12 (60%) of the 20 Italian regions were fully covered by NETS, 3 (15%) regions were partially covered, while neonatal transport was not available in 5 (25%) regions. Overall, in 2014, the 44 NETS operating in Italy transported a total of 6387 infants, including 522 (8.17%) having a gestational age<28weeks.ConclusionsThe organization of NETS in Italy is devolved on a regional basis, resulting in a large heterogeneity of access and quality to services across the country. Where available, NETS are generally well-equipped and organized but limited volume of activities often cannot guarantee adequate levels of skills of personnel or an appropriate cost-efficiency ratio. The regions reported with lack of NETS have managed, or are trying, to fill the gap, but continuing efforts to reduce regional differences in the availability and quality of services are still needed.
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