Neonatal intensive care units in Istanbul (2014-2015)

Objective: The aim of the study was to determine the changes and current status of neonatal intensive care units (NICUs) in process in Istanbul between 2014 and 2015.
Material and Method: The study was performed and evaluated by considering the current data belonging to years of 2014 and 2015 of NICUs from the Public Inpatient Health Services and Emergency Health Services Branch Offices of Istanbul Provincial Health Directorate.
Results: The total number of neonatal beds in Istanbul was 1870 by the year 2014 [Level I: 290 (15.5%), Level II: 555 (29.7%), Level III: 1025 (54.8%)] while this number rose up to 2268 [Level I: 365 (16.1%), Level II: 685 (30.2%), Level III: 1228 (53.7%)] with an increase of 21.2% in 2015. Approximately 27.3% of these beds were located in public health institutions and the rate of neonatologists available was about 40.5% of neonatal beds in Istanbul. More than half of patients were treated in Level III beds. In 2014 18.2% and in 2015, 16.1% of newborn in Istanbul received inpatient treatment during the neonatal period and it is noteworthy that nearly half of them (in 2014 47.8%, in 2015 45.3%) were monitored in Level III beds.
Conclusions: The number of neonatal beds and neonatologists has increased substantially (21.2%) in Istanbul last year. But when it was considered at the international level, the distribution of the number of the neonatal beds was distorted, and the number and working order of neonatologists were inadequate. Regionalization of perinatal care for Istanbul must be performed immediately. The updating of official regulations for ensuring service delivery is required with considering realistic goals and determination of emergency action plan in terms of health policies for newborn health with all participants that give newborn care.

Ýstanbul’da yenidoðan yoðun bakým üniteleri (2014-2015)

Amaç: Çalýþma Ýstanbul ilinde Yenidoðan Yoðun Bakým Ünitelerinin (YYBÜ) 2014 ve 2015 yýllarýndaki mevcut durumu ve deðiþikliklerini ortaya koymak amacýyla yapýldý.
Gereç ve Yöntem: Çalýþma Ýstanbul Ýl Saðlýk Müdürlüðü Kamu Yataklý Saðlýk Hizmetleri ve Acil Saðlýk Hizmetleri Þube Müdürlüklerinin YYBÜ’lere ait 2014 ve 2015 yýlý güncel verileri eþliðinde gerçekleþtirildi.
Bulgular: Ýstanbul’da toplam yenidoðan yatak sayýsý 2014 yýlý itibarý ile 1870 [1.düzey: 290 (%15,5), 2. düzey: 555 (%29,7), 3.düzey: 1025 (%54,8)] iken bu sayý 2015 yýlýnda %21,2’lik bir artýþ ile 2268’e [1.düzey: 365 (%16,1), 2. düzey: 685 (%30,2), 3.düzey: 1228 (%53,7)] yükselmiþtir. Bu yataklarýn yaklaþýk %27’si kamuya ait saðlýk kuruluþlarýnda yer almaktadýr ve ancak %40’ýnda neonatolog mevcuttur. Hastalarýn yarýsýndan fazlasý 3. düzey yataklarda tedavi görmüþtür. Ýstanbul’da bir yýlda doðan bebeklerin 2014 yýlýnda %18,2’sinin 2015 yýlýnda ise %16,1’inin yatarak tedavi aldýðý ve bu yenidoðanlarýn da yaklaþýk yarýsýnýn (2014 yýlýnda %47,8, 2015 yýlýnda %45,3) 3. düzey yataklarda izlendiði dikkati çekmektedir.
Sonuç: Ýstanbul’da yenidoðan yataðý ve neonatoloji uzmaný sayýsý son 1 yýlda ciddi oranda (%21,2) artmýþtýr. Fakat uluslararasý düzeyde ele alýndýðýnda yenidoðan uzmaný sayýsýnýn yetersiz, çalýþma düzeninin ve yatak sayýlarýnýn daðýlýmýnýn bozuk olduðu saptanmýþtýr. Perinatal bakýmýn bölgeselleþtirme çalýþmalarý acilen baþlanmalýdýr. Yenidoðan hizmet sunumunun akýlcý koþullarda tüm paydaþlarýn katýlýmý ile deðerlendirilerek temel saðlýk politikalarýnda acil eylem planý olarak ele alýnmasý gereklidir.