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[Neonatal medicine at the appropriate level of care?].

BACKGROUND
To explore the utilisation of neonatal care resources in the region.


METHOD
Place of birth, unit of admission, ventilator treatment, total and "unnecessary" length of stay in a tertiary unit, and to which location the children were discharged, were recorded from medical records of sick newborns from Finnmark transferred to the University Hospital of North Norway during 1992-99.


RESULTS
255 newborns from Finnmark County were admitted to the University Hospital, of which 175 (69%) were delivered at the University Hospital. 70 (28%) were primarily admitted to an inappropriate level of care. 93% of preterms less than 32 weeks of gestational age and 85% of preterms at 32-35 weeks were transported inutero to the University Hospital. In 16% of hospital days at the University Hospital, the level of care was considered inappropriate. 50% of the children were discharged to hospitals in Finnmark County, while 41% went home directly. 58% of the preterms spent their last days in hospital in the neonatal care unit in Hammerfest.


CONCLUSION
Improvements could be made to the allocation of patients to appropriate level of care. Preterms less than 32 weeks are adequately selected for inutero transport. A higher proportion of large preterms should be delivered and treated at the neonatal care unit in Hammerfest.