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Why and How Was Regionalization of Perinatal Care Accomplished in Portugal?

dc.contributor.authorNeto, MT
dc.date.accessioned2013-02-20T11:50:03Z
dc.date.available2013-02-20T11:50:03Z
dc.date.issued2011
dc.description.abstractPortuguese 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.por
dc.identifier.citationIN: 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, Argentinapor
dc.identifier.urihttp://hdl.handle.net/10400.17/1103
dc.language.isoengpor
dc.publisherUnidade de Cuidados Intensivos Neonatais, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPEpor
dc.subjectServiço Nacional de Saúdepor
dc.subjectCuidados Intensivos Neonataispor
dc.subjectPortugalpor
dc.subjectRegionalizaçãopor
dc.subjectHDE UCI NEO
dc.titleWhy and How Was Regionalization of Perinatal Care Accomplished in Portugal?por
dc.typelecture
dspace.entity.typePublication
rcaap.rightsopenAccesspor
rcaap.typelecturepor

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