Nationwide survey of neonatal transportation practices in Italy
Abstract Background Despite 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...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-04-01
|
| Series: | Italian Journal of Pediatrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13052-019-0640-z |
| _version_ | 1798044882056511488 |
|---|---|
| author | Maurizio Gente Roberto Aufieri Rocco Agostino Tiziana Fedeli Maria Grazia Calevo Paolo Massirio Carlo Bellini on behalf of the Neonatal Transport Study Group of the Italian Society of Neonatology (SIN) |
| author_facet | Maurizio Gente Roberto Aufieri Rocco Agostino Tiziana Fedeli Maria Grazia Calevo Paolo Massirio Carlo Bellini on behalf of the Neonatal Transport Study Group of the Italian Society of Neonatology (SIN) |
| author_sort | Maurizio Gente |
| collection | DOAJ |
| description | Abstract Background Despite 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. Methods A 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). Results The 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 < 28 weeks. Conclusions The 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. |
| first_indexed | 2024-04-11T23:11:25Z |
| format | Article |
| id | doaj.art-da3d848e0a9443aba7f414277e74668c |
| institution | Directory Open Access Journal |
| issn | 1824-7288 |
| language | English |
| last_indexed | 2024-04-11T23:11:25Z |
| publishDate | 2019-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Italian Journal of Pediatrics |
| spelling | doaj.art-da3d848e0a9443aba7f414277e74668c2022-12-22T03:57:50ZengBMCItalian Journal of Pediatrics1824-72882019-04-014511910.1186/s13052-019-0640-zNationwide survey of neonatal transportation practices in ItalyMaurizio Gente0Roberto Aufieri1Rocco Agostino2Tiziana Fedeli3Maria Grazia Calevo4Paolo Massirio5Carlo Bellini6on behalf of the Neonatal Transport Study Group of the Italian Society of Neonatology (SIN)Department of Pediatrics and Infant Neuropsychiatry, Neonatal Emergency Transport Service, Sapienza University of RomeDivision of Neonatology and Neonatal Intensive Care Unit, ASL Roma 2 – Ospedale Sant’EugenioDivision of Neonatology, Villa Margherita Private Nursing HomeNeonatal Intensive Care Unit, Fondazione MBBMDepartment of Epidemiology, Biostatistics and Committees, IRCCS Istituto Giannina GasliniNeonatal Intensive Care Unit, Neonatal Emergency Transport Service, Department Mother&Child, IRCCS Istituto Giannina GasliniNeonatal Intensive Care Unit, Neonatal Emergency Transport Service, Department Mother&Child, IRCCS Istituto Giannina GasliniAbstract Background Despite 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. Methods A 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). Results The 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 < 28 weeks. Conclusions The 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.http://link.springer.com/article/10.1186/s13052-019-0640-zInfant, newbornIntensive care, neonatal transportPerinatal careRegional medical programsHealth services accessibility |
| spellingShingle | Maurizio Gente Roberto Aufieri Rocco Agostino Tiziana Fedeli Maria Grazia Calevo Paolo Massirio Carlo Bellini on behalf of the Neonatal Transport Study Group of the Italian Society of Neonatology (SIN) Nationwide survey of neonatal transportation practices in Italy Italian Journal of Pediatrics Infant, newborn Intensive care, neonatal transport Perinatal care Regional medical programs Health services accessibility |
| title | Nationwide survey of neonatal transportation practices in Italy |
| title_full | Nationwide survey of neonatal transportation practices in Italy |
| title_fullStr | Nationwide survey of neonatal transportation practices in Italy |
| title_full_unstemmed | Nationwide survey of neonatal transportation practices in Italy |
| title_short | Nationwide survey of neonatal transportation practices in Italy |
| title_sort | nationwide survey of neonatal transportation practices in italy |
| topic | Infant, newborn Intensive care, neonatal transport Perinatal care Regional medical programs Health services accessibility |
| url | http://link.springer.com/article/10.1186/s13052-019-0640-z |
| work_keys_str_mv | AT mauriziogente nationwidesurveyofneonataltransportationpracticesinitaly AT robertoaufieri nationwidesurveyofneonataltransportationpracticesinitaly AT roccoagostino nationwidesurveyofneonataltransportationpracticesinitaly AT tizianafedeli nationwidesurveyofneonataltransportationpracticesinitaly AT mariagraziacalevo nationwidesurveyofneonataltransportationpracticesinitaly AT paolomassirio nationwidesurveyofneonataltransportationpracticesinitaly AT carlobellini nationwidesurveyofneonataltransportationpracticesinitaly AT onbehalfoftheneonataltransportstudygroupoftheitaliansocietyofneonatologysin nationwidesurveyofneonataltransportationpracticesinitaly |