建立区域性危重新生儿救治分中心的有效性研究

Efficiency of Establishing Regional Cure Branch Centers for Critical Neonates

目的探讨建立区域性危重新生儿救治分中心对降低基层医院新生儿病死率、提高基层医院新生儿急救技术的有效性。方法在有条件的二级妇幼保健院按照准入标准建立危重新生儿救治分中心,采取一系列质量监管措施,比较分中心建立前后1年的医疗质量指标、科研教学情况和经济指标。结果区域性危重新生儿救治各分中心建立后1年,其年住院患儿数、危重患儿数、抢救成功率等均有不同程度的升高,患儿年病死数有不同程度的降低。窒息复苏新教程考核通过率除1所分中心外均有所提高,且通过率均在90%以上。多数分中心的新生儿窒息发生率有不同程度的下降,经济收入均有所增长,且科研教学意识提高。结论建立区域性危重新生儿救治分中心在有利于省中心自身发展的同时,能改变基层医院信息落后的局面,合理利用医疗资源,有效地促进基层妇幼保健院医疗、科研的发展,使病理新生儿的存活率明显提高,降低致残率,且医疗费用恰当,符合中国国情,值得大力推广。

Objective To explore the efficiency of establishing regional critical neonate cure branch centers in decreasing the mortality of neonates and improving the neonatal emergency technology in the hospitals in primary level. Methods According to the admittance standards, critical neonate cure branch centers were founded in the qualified level Ⅱ maternal and child health hospitals, meanwhile, a series of measures of quality supervision were adopted. We compared the situation of one year before the foundation of centers with that of after the foundation about the quality index of medical care, scientific research and teaching as well as economic indicator. Results During one year after the establishment of regional critical neonate cure branch centers,the annual amount of the inpatients and critical patients as well as the rescue achievement ratio increased,the annual mortality rate reduccd,the rate of passing the new teaching test of asphyxia rescue increased and was above 90% in all centers except one, the incidence of neonatal asphyxia decreased in majority of the centers, both financial income and the capability of scientific research and teaching enhanced. Conclusion The establishment of regional critical neonate cure branch centers is beneficial to improve the provincial central hospital as well as the hospitals in primary level. It utilizes medical resource efficiently, promotes the maternal and child health hospitals in primary level to develop diagnosis and treatment as well as scientific research. The establishment is beneficial to raise the survival rate of the pathological neonate, degrade disability rate of the pathological neonate.The medical cost was expended appropriately, so it is worth to be spread generally according to Chinese situation.