Evaluation of neonatal mortality in Buenos Aires City by place of residence and use of a health system subsector.
Neonatal mortality is the most important component of infant mortality. Analyzing neonatal mortality is complex and does not depend exclusively on the health system. In Buenos Aires City (CABA), between2000 and 2012, neonatal mortality rate was lower than the national mean rate but no changes were recorded. Besides, the difference is narrowing: in 2000, it was 46% lower but in 2012, it was 21% lower.



To assess the relationship among the place of maternal residence, the use of a health system subsector, and mortality rate among newborn infants younger than 28 days old in CABA.



Cross-sectional, population-based study conducted in 2011 and 2012 using data from the Office of Vital Records and the Department of Statistics and Surveys of CABA.



A total of 164 837 births were recorded. The ratio of births in public and private facilities has remained stable; the private subsector accounts for 57% ofbirths. The ratiobetweenbothsubsectors was also similar in terms of gender, birthweight, and average gestational age. Neonatal mortalitywas higher among mothers who lived outside CABA (6.55%o versus 5.42%, odds ratio: 1.21, 95% confidence interval: 1.07-1.37, p 0.0039). Among mothers living in CABA, neonatal mortality was higher in the public health subsector (7.8% versus 4.4%, odds ratio: 1.77, 95% confidence interval: 1.48-2.11, p < 0.001).



Unlike any other district in Argentina, CABA has a very high rate of births and deaths from other jurisdictions, especially from Greater Buenos Aires, which is not reflected in official statistics that only consider the place of parental residence.
Servicio de Neonatologia, Hospital Materno Infantil "Ramón Sardá", Ciudad Autónoma de Buenos Aires, Argentina. jmeritano@gmail.com.
Javier
J
Meritano
Servicio de Neonatologia, Hospital Materno Infantil "Ramón Sardá", Ciudad Autónoma de Buenos Aires, Argentina.
Lorena
L
Tsavoussian
Servicio de Neonatologia, Hospital Materno Infantil "Ramón Sardá", Ciudad Autónoma de Buenos Aires, Argentina.
Raúl
R
Címbaro Canella
Servicio de Neonatologia, Hospital Materno Infantil "Ramón Sardá", Ciudad Autónoma de Buenos Aires, Argentina.
Claudio
C
Solana
D001118:Argentina / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D017149:Private Sector; D017150:Public Sector; D012111:Residence Characteristics; D014504:Urban Health
Epidemiological factors; Health systems; Neonatal mortality; Regionalization