title: The impact of neonatal care resources on regional variation in neonatal mortality among very low birthweight infants in Korea.
abstract: BACKGROUND
  Faced with extremely low fertility rates and increasing numbers of low-birthweight births in Korea, we examined the factors affecting the mortality of very-low-birthweight (VLBW) infants in Korea.
  
  
  METHODS
  A survey was conducted in 91 of 93 hospitals providing neonatal intensive care in Korea in 2009. Data included information on number of neonatal intensive care unit (NICU) beds, medical workforce, resources in the NICU, birth and death.
  
  
  RESULTS
  There was approximately one NICU per 4888 births, one NICU bed per 355 births, one mechanical ventilator per 739 births, one incubator per 327 births and one board-certified neonatologist per 4683 births. Regional disparity existed in neonatal care resources and consequently in mortality rates. VLBW infants' mortality was related to the NICU facility level, volume of VLBW infants and geographic regions. The capital city, Seoul, has the best NICU facilities and workforce, and the least mortality. Overall mortality rates before hospital discharge for <750, 750-999 and 1000-1499 g were 44.8%, 20.4% and 6.5% respectively. There was a two to threefold difference in the mortality rates across the regions. However, following adjustments for NICU facility level and volume of VLBW infants admissions, regional difference in mortality rates was markedly reduced in the <750 g and disappeared in the larger VLBW groups.
  
  
  CONCLUSIONS
  Regional disparity in mortality of VLBW infants in Korea is most marked in the lowest-birthweight group, <750 g. This disparity is primarily due to lack of resources for neonatal intensive care in most of provincial areas.
authors: Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Jae Won
authors: JW
authors: Shim
authors: Myo Jing
authors: MJ
authors: Kim
authors: Ee-Kyung
authors: EK
authors: Kim
authors: Hyun Kyung
authors: HK
authors: Park
authors: Eun Song
authors: ES
authors: Song
authors: Soon Min
authors: SM
authors: Lee
authors: Jang Hoon
authors: JH
authors: Lee
authors: Hyun-Seung
authors: HS
authors: Jin
authors: Eun Sun
authors: ES
authors: Kim
authors: Yun Sil
authors: YS
authors: Chang
mesh_terms: D001723:Birth Rate; D005260:Female; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data; D006761:Hospitals; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D056910:Republic of Korea