海南省新生儿救治能力现状分析及对策思考

Status quo analysis of neonatal treatment capacity in Hainan Province and consideration of countermeasures

目的 通过对2019年海南省县以上公立医院新生儿病房进行横断面数据调查,探讨省内县以上公立医院危重新生儿救治能力的现状,为提出降低新生儿病死率、减少致残率及改善预后的新生儿能力建设体系提供理论依据。方法 对2019年海南省30家二级以上公立医院新生儿科的配备情况、医师的人员结构、救治设备和药物的配置等进行分析。结果 30家公立医院中,新生儿独立成科11家(36.67%);隶属儿科但独立分区17家(56.67%)。30家公立医院中NICU床位数<15张20家(66.67%),15~20张6家(20.00%),>20张4家(13.33%);新生儿床位数<20张10家(33.33%),20~39张12家(40.00%),40~59张5家(16.67%),≥60张3家(10.00%)。30家公立医院中新生儿科医师共有255名,在新生儿科工龄≥3年以上200名(78.43%),<3年55名(21.57%);博士、硕士研究生28名(10.98%),本科208名(81.57%);高级职称70名(27.45%),中级职称89名(34.90%),初级职称96名(37.65%)。结论 新生儿病房主要设置在二级以上综合医院,二级妇幼专科医院场地及设备明显缺乏,人员专科化不足,服务能力不足。应进一步增强基层妇幼保健院建设,注重妇幼保健一级预防。

Objective To explore the current status of the emergency treatment capacity of the secondlevel and above medical institutions in the province through a cross-sectional data survey of neonatal wards in public hospitals above the county level in Hainan Province in 2019,in order to provide a theoretical basis for proposing a neonatal capacity building system to reduce neonatal morbidity and mortality,reduce disability and improve prognosis.Methods The staffing of neonatal departments,the staffing structure of physicians,and the allocation of life-saving equipment and drugs in 30 public hospitals above the second level in Hainan Province in 2019 were analyzed.Results Among the 30 public hospitals,11 hospitals(36.67%)had separate neonatal departments;17 hospitals(56.67%)were affiliated with pediatrics but had separate subdivisions.The number of NICU beds in 30 public hospitals was<15 beds in 20 hospitals(66.67%),15-20 beds in 6 hospitals(20.00%),>20 beds in 4 hospitals(13.33%);the number of neonatal beds was<20 beds in 10 hospitals(33.33%),20-39 beds in 12 hospitals(40.00%),40-59 beds in 5(16.67%),≥60 beds in 3 hospitals(10.00%).There were 255 neonatologists in 30 public hospitals,with 200 cases(78.43%)working in neonatology for≥3 years and 55 cases(21.57%)for<3 years.There were 28 doctors and masters(10.98%),208 undergraduates(81.57%).There were 70 senior titles(27.45%),89 intermediate titles(34.90%),and 96 junior titles(37.56%).Conclusion Neonatal wards are mainly set up in general hospitals above the second level,and there is an obvious lack of space and equipment in secondary maternal and child specialist hospitals,insufficient staff specialization and insufficient service capacity.The construction of primary maternal and child health care hospitals should be further enhanced,focusing on primary prevention of maternal and child health care.