The Effects of Patient Volume and Level of Care at the Hospital of Birth on Neonatal Mortality

Effect of Deregionalized Care on Mortality in Very Low-Birth-Weight Infants With Necrotizing Enterocolitis

“…5,[19][20][21][22][23][24] Among VLBW infants with NEC, mortality was significantly increased at level IIIA and IIIB low-volume NICUs compared with the mortality for VLBW infants born into level IIIB/IIIC high-volume NICUs. We did not find a significant increase in mortality for those with NEC born into the lowest level of care (level II NICUs).…”

Obstetrical volume and early neonatal mortality in preterm infants

“…In a study from South Carolina, levels of care were defined by both, availability of medical speciality and subspeciality care as well as by volume of annual deliveries (Level III ‡ 1,500 annual deliveries), and lower neonatal mortality and shorter hospital stays among VLBW-neonates were reported for Level III centres [1]. Third, minimal caseload/ volume criteria for NICUs are often linked to a specific subpopulation at risk, such as gestational age \32 weeks [27], or birthweight 500-1,499 g [1,6,21,28], based on the concept that neonates being at highest risk will benefit most from centralised perinatal care. In contrast, previous studies on the impact of obstetrical volume and perinatal outcome referenced to all deliveries [4,11,25,26].…”

“…Discussed cut-offs range from 1,500 to 2,000 annual deliveries [4], but have not yet been implemented consistently. Moreover, delivery unit and NICU are usually combined within perinatal centres, thus the individual impact of the delivery vs. neonatal unit volume cannot be distinguished [5][6][7].…”

Enquête de satisfaction auprès de 75 professionnels de la région Rhône-Alpes sur la mise en place d’une cellule régionale de régulation des transferts périnatals. L’avenir de cette structure est-il envisageable sur l’ensemble du territoire français ?

“…Ces résultats sont retrouvés dans plusieurs études [10][11][12][13][14][15][16][17]. À la fin des années 1990, le concept de régionalisation apparaît et la mise en place des réseaux périnatals a pour objectif de faciliter les transferts in utero et néonatals.…”