[Access to a III level neonatal intensive care unit in Argentina].
BACKGROUND
In Argentina information does not exist about how many newborns (NB) who need to be hospitalized in a third level neonatal intensive care unit (NICU) actually accede, not even about the evolution of those who cannot accede.


OBJECTIVE
To analize the characteristics of NB that required to be hospitalized in a NICU and the evolution of those who do not accede.


METHODS
Longitudinal, prospective and observational study. There were included NB that required hospitalization in the NICU of the Hospital Garrahan during eleven months. Every request was registered and phone calls were made to know the evolution of rejected NB. The accessibility was analyzed by bivariated and multivariated tests.


RESULTS
1197 NB were included in the study; 75% with severe clinical condition, being of higher frequency the cardiac, respiratory and surgical pathologies; 637 NB (53%) were accepted. The NB from other provinces (OR 2, IC95% 1.4-2.8), retinophaty of the premature (OR 40, IC95% 14-85) and surgical disease (OR 1.99, IC95% 1.4-2.7) were independent factors that increased the possibilities to access; it decreased during the winter (OR 0.56, IC95% 0.40-0.77); 56 NB died; 47 could not have access to a third level NICU in spite of presenting pathologies sensitive of treatment.


CONCLUSIONS
This information shows the fact that is of high importance to define regional strategies that allow the efficient administration of existing health resources and the opportune access of seriously ill NB patients to reference centers.
Rabasa
Cecilia
C
Hospital Nacional de Pediatría Prof. Dr. Juan P. Garrahan. crabasa@intramed.net.ar
Bossi
Lucrecia
L
Santos
Paula
P
Rodríguez
Susana
S
Fariña
Diana
D
D001118:Argentina; D005260:Female; D006297:Health Services Accessibility / Q000145:classification / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D008297:Male; D011446:Prospective Studies