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J Korean Med Assoc > Volume 49(11); 2006 > Article
Shin: The Current Status and a Prospect of Neonatal Intensive Care Units in Korea

Abstract

Neonatal intensive care in Korea has improved remarkably since the 1990's, but there is still a shortage of facilities and equipments in neonatal intensive care units (NICUs). Only 61.7% of hospital beds needed for neonatal intensive care are available, the given area per bed is limited, and other facilities such as on-call rooms, interview rooms, closets are insufficient. Mechanical ventilators are not appropriately distributed to NICUs that are equipped to handle neonatal intensive care. The number of physicians for neonatal intensive care is by far too small, with the number of patients per physician being very high. The number of patients per nurse, too, is as high as 5.3 to 7.3, making it very difficult to provide adequate intensive care. All these are caused by the insufficient investment by the hospitals, which is due to the inadequate reimbursement from the health insurance. Therefore, government-driven efforts are necessary to bring the level of neonatal intensive care service up to par.

References

1. Shin SM, Namgung R, Oh YK, Yoo BH, Jun YH, Lee KH. A survey on the current status of neonatal intensive care units for the planning of regional perinatal care system in Korea. J Korean Soc Neonatol 1996;3:1-8.

2. Han YJ, Seo K, Shin SM, Lee SW, Do SR, Chang SW. Low birth weight outcomes and policy issues in Korea. Korea Institute for Health and Social affairs 1999.

3. Hwang NM, Kim KS, Shin SM, Pi SY, Kim KS. Registration and medical support system for prematurity and congenital anomalies. Korea Institute for Health and Social affairs 2000.

4. Guide to completeing the facility worksheets for the certificate of live birth and report of fetal death (2003 version). National Center of Health Statistics, Division of Vital Statistics 2006;Accessed October 10. Available at http://www.cdc.gov/nchs/data/dvs/GuidetoCompleteFacilityWks.pdf

5. American Academy of Pediatrics and The American College of Obstetricians and Gynecologists. Guidelines for perinatal care 2002;5th ed.

6. Committee on Fetus and Newborn. American Academy of Pediatrics. Levels of neonatal care. Pediatrics 2004;114:1341-1347.

7. Jung AL, Streeter NS. Total population estimate of newborn special-care bed needs. Pediatrics 1985;75:993-996.

8. National vital statistics report 2005. Korea National Statistical Office 2006;Accessed October 10. Available at http://www.nso.go.kr

Table 1
Definitions of levels of neonatal care
jkma-49-983-i001-l.jpg
Table 2
Service areas of neonatal intensive care units (m3)
jkma-49-983-i002-l.jpg

*percentage of the recommended area of AAP & ACOG(5)

Table 3
Installed gas outlets per bed in neonatal intensive care units
jkma-49-983-i003-l.jpg
Table 4
Percentage of the prepared supporting service areas in neonatal intensive care units (%)
jkma-49-983-i004-l.jpg
Table 5
Number of infant ventilators in neonatal intensive care units
jkma-49-983-i005-l.jpg
Table 6
Distribution of hospitals by the number of infant ventilators(1999)
jkma-49-983-i006-l.jpg
Table 7
Medical doctors in neonatal intensive care units
jkma-49-983-i007-l.jpg
Table 8
Distribution of hospitals by the number of infant ventilators per resident(1999)
jkma-49-983-i008-l.jpg
Table 9
Nursing personnels in neonatal intensive care units
jkma-49-983-i009-l.jpg
Table 10
Distribution of hospitals by the number of infant ventilators and patients per nurse(1999)
jkma-49-983-i010-l.jpg
Table 11
Beds for neonatal intensive care by regions
jkma-49-983-i011-l.jpg

*one bed per 1,000 live birth



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