[Tertiary obstetric care: the aims of the planning decree on perinatal care of 2001 have not yet been achieved].
OBJECTIVE
To compare the actual situation in tertiary perinatal care in the Netherlands with the objectives laid down in the 2001 decree on perinatal care by the Dutch Ministry of Health, Welfare and Sport.


METHODS
Descriptive, retrospective.


METHODS
Data on tertiary perinatal care, the transfer or refusal of women with very endangered pregnancies and the personnel of obstetric high care (OHC) units in 2006 were compared with the targets laid down in the planning decree on perinatal care and in a report by the Dutch Health Council from 2000. Parameters of tertiary perinatal care output were the number of admissions, and the number of beds in OHC units and neonatal intensive care units (NICU).


RESULTS
In 2006, 128 of the 250 beds intended for OHC had been obtained. The degree of capacity utilisation was 94%, while the norm is 80%. 312 women were transferred due to lack of capacity of OHC units and NICU. The number of staff, specialised physicians as well as nurses, was considerably lower than the planned capacity. But training for obstetric perinatologists and OHC nurses was given.


CONCLUSIONS
The targets for the number of beds for tertiary obstetric care and associated medical personnel have not been achieved as yet. As a consequence, the number of transfers is still too high. The funding of OHC units is not attuned to the complexity of tertiary perinatal care. Closer supervision of the execution of the planning decree and an adequate financing system are needed to achieve the objectives of the planning decree in the next 3 years.
Isala klinieken, locatie Sophia, afd. Gynaecologie en Verloskunde, Dr.Van Heesweg 2, 8025 AB Zwolle. jvaneyck@wxs.nl
J
J
van Eyck
K W M
KW
Bloemenkamp
A C
AC
Bolte
J J
JJ
Duvekot
M P
MP
Heringa
F K
FK
Lotgering
S G
SG
Oei
J P M
JP
Offermans
A H P
AH
Schaap
K M
KM
Sollie-Szarynska
D001509:Bed Occupancy / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand; D006742:Hospital Bed Capacity; D006801:Humans; D007363:Intensive Care Units, Neonatal / Q000592:standards / Q000706:statistics & numerical data; D008430:Maternal-Child Health Centers / Q000592:standards*; D008880:Midwifery; D009426:Netherlands; D010360:Patient Transfer / Q000706:statistics & numerical data*; D018743:Perinatal Care / Q000592:standards*; D011247:Pregnancy; D011787:Quality of Health Care; D012189:Retrospective Studies
Derdelijns verloskundige zorg: doelstellingen van het 'planningsbesluit bijzondere perinatologische zorg' uit 2001 nog niet gehaald.