Nordic hospitals discharge premature infants under wildly different protocols
A new survey across Nordic countries reveals hospitals have no consensus on when or how to discharge infants born very prematurely, creating potential quality gaps and cost variations. The findings expose a coordination problem that could affect neonatal outcomes and healthcare efficiency across the region.
Originaltitel: Nordic survey showed wide variation in discharge practices for very preterm infants
<p>Aim</p><p>We aimed to describe clinical practices and criteria for discharge of very preterm infants in Nordic neonatal units.</p><p>Methods</p><p>Medical directors of all 89 level-2 and level-3 units in Denmark, Finland, Iceland, Norway and Sweden were invited by e-mail to complete a web-based multiple-choice survey with the option to make additional free-text comments.</p><p>Results</p><p>We received responses from 83/89 units (93%). In all responding units, discharge readiness was based mainly on clinical assessment with varying criteria. In addition, 36% used formal tests of cardiorespiratory stability and 59% used criteria related to infant weight or growth. For discharge with feeding tube, parental ability to speak the national language or English was mandatory in 45% of units, with large variation among countries. Post-discharge home visits and video-consultations were provided by 59% and 51%, respectively. In 54% of units, parental preparation for discharge were not initiated until the last two weeks of hospital stay.</p><p>Conclusion</p><p>Discharge readiness was based mainly on clinical assessment, with criteria varying among units despite similar population characteristics and care structures. This variation indicates a lack of evidence base and may unnecessarily delay discharge; further studies of this matter are needed. Earlier parental preparation and use of interpreters might facilitate earlier discharge.</p>