The Medical Effects and Cost of Hospitalized Tocolysis on Neonatal Babies

• Main Authors: Te-Hsin Chang, 張德馨
• Other Authors: Ching-Wen Chien
• Format: Others
• Language: zh-TW
• Published: 2011
• Online Access: http://ndltd.ncl.edu.tw/handle/99103951251993243726

碩士 === 國立陽明大學 === 醫務管理研究所 === 99 === Objective The essential goal of preventing premature infants’ complications is to increase the gestational weeks and reduce the incidence of preterm birth on pregnant woman with tendency of preterm birth. This study was to examine the difference of characteristics of the maternal and newborn, birth outcomes, and medical utilizations between the short-term tocolysis (≦2days) and long-term tocolysis (＞2days). The results will be a reference for tocolytics care policy. Methods A retrospective study was designed to compare the complications of the maternal and newborns, whose gestation ＜37 weeks, from the population-based in a medical center and National Health Care Insurance (NHI) from 2004 to 2005. The subjects were divided by days of inpatient tocolysis to case group (＞2days) and control group (≦2 days). There were 354 newborns in case group, while there were 197 newborns in control group. Results (1) In birth weight, the first minute and fifth minute of the Apgar scores, first aid or not, the number of first hospitalized complications were significant difference. Gestational age, weight and birth outcomes of newborn in case group were better than that in control group. (2) There was no significant difference in medical utilizations of neonatal (birth to one year old) in two groups. (3) The difference of medical care utilization was according to the gestation weeks of infants (24-28 weeks and 29-32 weeks) and no difference with days of inpatient tocolysis. (4) The medical care utilization of neonatal were significant difference with the major complications of mother in difference stage of pregnancy, but no difference with two groups in same complication. (5) Compared to newborns without tocolysis, the more tocolysis days, the more weeks of newborns’ age and the heavier weight of newborn, but no difference between the medical care utilization and days of tocolysis. Conclusions Gestational age was a major factor in neonatal care utilization, hospitalization of tocolysis did tend to make to extend the gestational weeks, thereby increasing birth weight, birth outcomes better. Since the different major complications during pregnancy, the total medical utilization of neonatal care was also affected. According to the results, tocolysis should be paid according to gestational age, pregnancy complications, and birth risk assessment of premature. Besides, the severity of complications during pregnancy should be considered to pay more to improve the quality of maternal and neonatal care. The results will be a suggestion to NHI to planning the reimbursement of TW-DRGs.