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  • Title: Cost is an important factor influencing active management of extremely preterm infants.
    Author: Ma L, Liu C, Cheah I, Yeo KT, Chambers GM, Kamar AA, Travadi J, Oei JL.
    Journal: Acta Paediatr; 2019 Jan; 108(1):70-75. PubMed ID: 30080290.
    Abstract:
    AIM: The attitudes of neonatologists towards the active management of extremely premature infants in a developing country like China are uncertain. METHODS: A web-based survey was sent to neonatologists from 16 provinces representing 59.6% (824.2 million) of the total population of China on October 2015 and December 2017. RESULTS: A total of 117 and 219 responses were received in 2015 and 2017, respectively. Compared to 2015, respondents in 2017 were more likely to resuscitate infants <25 weeks of gestation (86% vs. 72%; p < 0.05), but few would resuscitate infants ≤23 weeks of gestation in either epoch (10% vs. 6%). In both epochs, parents were responsible for >50% of the costs of intensive care, but in 2017, significantly fewer clinicians would cease intensive care (75% vs. 88%; p < 0.05) and more would request for economic aid (40% vs. 20%; p < 0.05) if parents could not afford to pay. Resource availability (e.g. ventilators) was not an important factor in either initiation or continuation of intensive care (~60% in both epochs). CONCLUSION: Cost is an important factor in the initiation and continuation of neonatal intensive care in a developing country like China. Such factors need to be taken into consideration when interpreting outcome data from these regions.
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