Current Status of Neonatologist Staffing and Workload in Korean Neonatal Intensive Care Units

Lee, Byong Sop; Lim, Jae Woo; Choi, Yong Sung; Kim, Ki-Soo

doi:10.5385/nm.2020.27.2.65

Cited by 3 publications

(1 citation statement)

References 24 publications

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“…The survival rate of VLBW infants was 86% from 2013 to 2016 [8]. According to a recent survey, 87% of NICUs responded that they could provide level III NICU care [9]. High-frequency oscillatory ventilation and inhaled nitric oxide are available in level III NICUs.…”

Section: Knn Neonatal and Perinatal Care In Koreamentioning

confidence: 99%

Outcomes at 18–24 Months of Infants with Birth Weight under 500 g Born in Korea during 2013–2017: A Nationwide Cohort Study

Kim,

Jung,

Lee

et al. 2023

Neonatology

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Introduction: This study aimed to investigate the outcomes of infants at 18–24 months born in the Korean Neonatal Network with a birth weight <500 g. Methods: The anthropometric and neurodevelopmental data of infants with a birth weight <500 g at a gestational age of ≥22 weeks who were registered in the Korean Neonatal Network 2013–2017 and followed up at a corrected age of 18–24 months were reviewed. Neurodevelopmental impairment was defined as the presence of any of the following: (1) cerebral palsy; (2) severe visual impairment; (3) hearing impairment; or (4) cognitive impairment. Cognitive impairment was defined as (1) a Bayley Scales of Infant Development-II Mental Development Index score <70; and (2) Bayley Scales of Infant and Toddler Development-III Cognitive and Language Composite scores <85. Cognitive testing was performed for infants with suspected problems upon clinician’s referral to developmental specialists. Results: At a median corrected age of 20 months, 26/52 (50%) of included infants had neurodevelopmental impairment. Cerebral palsy, severe visual impairment, wearing of glasses, hearing impairment, and cognitive impairment occurred in 22%, 0%, 8%, 5%, and 57% of the included infants, respectively. The proportions of infants with <2 standard deviations of weight, length, and head circumference were 54%, 52%, and 56%, respectively. The majority (70%) of infants were rehospitalized, and the most common cause was respiratory problems. Conclusion: Half of infants with a birth weight <500 g in Korea may exhibit neurodevelopmental impairment and growth retardation at a corrected age of 18–24 months. Multidisciplinary follow-up along with continuous rehabilitation will be needed to improve neurological and physical development in this special population.

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Section: Knn Neonatal and Perinatal Care In Koreamentioning

confidence: 99%

Outcomes at 18–24 Months of Infants with Birth Weight under 500 g Born in Korea during 2013–2017: A Nationwide Cohort Study

Kim,

Jung,

Lee

et al. 2023

Neonatology

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Neonatologist staffing is related to the inter-hospital variation of risk-adjusted mortality of very low birth weight infants in Korea

Lee,

Chang

2024

Sci Rep

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Mortality of very low birth weight infants by neonatal intensive care unit workload and regional group status

Chung,

Kim,

Choi

et al. 2024

Clin Exp Pediatr

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Background: Very low birth weight infants (VLBWIs) continue to face high mortality risk influenced by the care quality of neonatal intensive care units (NICUs). Under-standing the impact of workload and regional differences on these rates is crucial for improving outcomes.Purpose: This study aimed to assess how the structural and staffing attributes of NICUs influence the mortality rates of VLBWIs, emphasizing the significance of the availability of medical personnel and the regional distribution of care facilities.Methods: Data from 69 Korean NICUs collected by the Korean Neonatal Network between January 2015 and December 2016 were retrospectively analyzed. The NICUs were classified by various parameters: capacity (small, medium, large), nurse-to-bed ratio (1–4), and regional location (A, B, C). Pediatrician staffing was also analyzed and NICUs categorized by beds per pediatrician into low (≤10), medium (11–15), and high (≥16). The NICUs were classified by mortality rates into high-performance (1st and 2nd quartiles) and low-performance (3rd and 4th quartiles). Demographic, perinatal, and neonatal outcomes were analyzed using multivariate logistic regression to explore the association between NICU characteristics and mortality rates.Results: This study included 4,745 VLBWIs (mean gestational age, 28.4 weeks; mean birth weight, 1,088 g; 55.4% male) and found significant variations in survival rates across NICUs linked to performance and staffing levels. High-performing NICUs, often with lower bed-to-staff ratios and advanced care levels, had higher survival rates. Notably, NICUs with 2 rather than 1 neonatologist were associated with reduced mortality rates. The study also underscored regional disparities, with NICUs in certain areas showing less favorable survival rates.Conclusion: Adequate NICU staffing and proper facility location are key to lowering the number of VLBWI deaths. Enhancing staffing and regional healthcare equity is crucial for improving the survival of this population.

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Current Status of Neonatologist Staffing and Workload in Korean Neonatal Intensive Care Units

Cited by 3 publications

References 24 publications

Outcomes at 18–24 Months of Infants with Birth Weight under 500 g Born in Korea during 2013–2017: A Nationwide Cohort Study

Outcomes at 18–24 Months of Infants with Birth Weight under 500 g Born in Korea during 2013–2017: A Nationwide Cohort Study

Neonatologist staffing is related to the inter-hospital variation of risk-adjusted mortality of very low birth weight infants in Korea

Mortality of very low birth weight infants by neonatal intensive care unit workload and regional group status

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