title: [Quality analyses of the development of preterm infants: results of the Lower-Saxonian preterm infant follow-up project and a comparison group of term infants].
abstract: Based on perinatal and neonatal quality assurance programmes, a follow-up project for the high-risk group of extremely preterm infants, unparalleled in Germany, was initiated in the federal state of Lower Saxony in 2004. Here we describe the new approach of examining a comparison group of term infants, which, for the first time, allows a valid interpretation of the collection of area-wide long-term outcome data on preterm children. The prospective long-term outcome project investigates the medical care situation for children born at less than 28 weeks of gestation up to school age. Based on the information obtained about the children's development the quality of health care will be optimised. A standardised examining concept with established development tests at defined follow-up intervals (at the age of 6 months, 2, 5 and 10 years) is used. At the age of five years 75 % of the examined premature children exhibited impairments. In order to better assess remarkable results, a comparison group of term infants (n=305) selected by a matched-pairs method was examined at the age of five using an analogous concept in kindergartens in Lower Saxony. The results were compared with the first two age cohorts of the follow-up-project (n=226) and quality analyses performed. As expected, significant differences have been found in the children's motor, cognitive and linguistic development between the preterm and term infants examined. This fact draws attention to the importance of early support for the majority of extremely premature infants. Feedback on the results given to the medical staff involved allows for the implementation of best practices and quality improvements. Identifying potential for improvement in everyday health care will help to develop specific optimisation measures.
authors.affiliation: Zentrum für Qualität und Management im Gesundheitswesen (ZQ), Einrichtung der Ärztekammer Niedersachsen, Hannover, Deutschland. Electronic address: gabriele.damm@aekn.de.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Damm
authors.affiliation: Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen, Deutschland.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Macha
authors.affiliation: Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen, Deutschland.
authors.forename: Franz
authors.initials: F
authors.lastname: Petermann
authors.affiliation: Sozialpädiatrisches Zentrum, AUF DER BULT, Zentrum für Kinder und Jugendliche, Hannover, Deutschland.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Voss
authors.affiliation: Zentrum für Qualität und Management im Gesundheitswesen (ZQ), Einrichtung der Ärztekammer Niedersachsen, Hannover, Deutschland.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Sens
mesh_terms: D019985:Benchmarking / Q000458:organization & administration; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D019984:Quality Indicators, Health Care / Q000458:organization & administration*; D012016:Reference Values; D017749:Total Quality Management / Q000458:organization & administration
keywords: Benchmarking; Hochrisikokollektiv; Nachuntersuchungen; Patientenorientierung; Prävention; Quality analysis; Qualitätsanalysen; Qualitätsforschung; Qualitätsmanagement; benchmarking; follow-up studies; high-risk group; patient orientation; prevention; quality management; quality of healthcare; quality research