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Advisor(s)
Abstract(s)
Portuguese health care system was created in 1979. It is universal and for free. Expenses
are supported by the State through taxes. The modern perinatal care system started by
the end of 1970. The first neonatal intensive care units were created in 1980, the Portuguese Neonatal Society in 1985 and the National Neonatal Transport System in
1987. Until the seventies of twentieth century and even during eighties there were more than 200 hospitals with deliveries, a great part without obstetrician or paediatrician, a great percentage of pregnancies had no prenatal care, there were few neonatal intensive care units and perinatal mortality rate was one of the highest in the European countries.
In 1987 an Experts Committee was nominated by the Health Ministry aiming to collect
and analyse data on perinatal care and to suggest improvements. The Report resulting
from this work is the main document on which is based the reform. The reform was a 9
years program in 3 years stages aiming to close hospitals with less than 1500
deliveries/year, to reclassify hospitals, to create Coordinating Units between health
centres and hospitals, to equip neonatal intensive and intermediate care units, to define needs of obstetricians, paediatricians and nurses for each centre and to promote specialised training in neonatology for paediatricians and nurses. Levels of perinatal care were defined as well as localization of each level of hospital according to the number of deliveries in one geographic area, geographic difficulties and existing routes
and connections. Steps for opening and closure of different levels of hospitals were very well programmed. The organization, capacities, number of obstetricians, neonatologists and nurses as well as equipment for each level of care was defined. Rules for pregnant women and newborns transfer from level II to level III hospitals were also well described. A specific training is neonatology was created starting in 1990. This organization resulted in an impressive decrease in mortality rates at all levels and still it is the policy we have today.
Description
Keywords
Serviço Nacional de Saúde Cuidados Intensivos Neonatais Portugal Regionalização HDE UCI NEO
Citation
IN: Jornada Internacional de Regionalización del Cuidado Perinatal. Direción Nacional de Maternidad e Infancía. Ministerio de Salud de la Nación; 2011, 11 a 13 Abril. Buenos Aires, Argentina
Publisher
Unidade de Cuidados Intensivos Neonatais, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE