Soins maternels intensifs (Maternal Intensive Care) en Belgique - KCE

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76 Maternal Intensive Care in Belgium KCE Reports 94 E. Apgar scores Table 37: Apgar scores at 1 and 5 minutes Newborn babies from each category of women Standard care Grey zone care Intermediate care Apgar score at 1 minute mothers mothers mothers 0-3 539 1.0% 782 2.3% 738 7.9% 4-6 2,265 4.2% 2,339 6.9% 831 8.9% 7-10 51,466 94.8% 30,673 90.8% 7,805 83.3% All 54,270 100.0% 33,794 100.0% 9,374 100.0% Nb of newborns with intensive care mothers = 786 - Missing and Incompleted data = 16 Apgar score at 5 minute 0-3 108 0.2% 138 0.4% 462 4.9% 4-6 382 0.7% 538 1.6% 229 2.4% 7-10 53,779 99.1% 33,117 98.0% 8,682 92.6% All 54,269 100.0% 33,793 100.0% 9,373 100.0% Nb of newborns with intensive care mothers = 786 - Missing and Incompleted data = 19 Source: Merged IMA and MKG/RCM Data 01/10/2003 – 30/09/2004 Admissions The proportion of newborns with a low Apgar score (0-3) at 1 minute increases from standard care to intensive care mothers. The differences are statistically significant (χ² test, p value < 0.0001). The low Apgar score (0-3) at 5 minutes increase from standard care to intermediate care. F. Proportion of admissions to NIC and N* Table 38: Proportion of neonates admitted to NIC and N* according to level of care 56 Newborn babies from each category of women Standard care mothers Grey zone care mothers Intermediate care mothers NIC 86 0.2% 2,165 6.4% 1,647 17.6% N* 8,554 15.8% 6,145 18.2% 2,119 22.6% Nb of newborns with intensive care mothers = 786 - Missing and Incompleted data = 5 Source: Merged IMA and MKG/RCM Data 01/10/2003 – 30/09/2004 The proportion of newborns admitted to a NIC-service or N*-service increases following the classification of mothers from standard care to intermediate care. The proportion of neonates staying in NIC-services varies from 0.2% in standard to 6.4% in the grey zone to 17.6% in intermediate care . The proportion of neonates staying in N* varies from 15.8% in standard to 18.2% in grey zone to 22.6% in intermediate care category. All these differences are statistically significant (χ² test, p value
KCE Reports 94 Maternal Intensive Care in Belgium 77 5.7.2 Comparison between theoretical and observed case-mix The classification of pathologies (see theoretical model) in different levels of care led to a "theoretical" model. An empirical index of 'MIC orientation' based on the data observation has been assigned to each pathology in order to determinate a list of pathologies that are more often treated in maternities with MIC-services. The index takes into account the proportion of MIC-beds of maternities where the women were treated. Practically, the index was created through the following steps: 1. Identifying the pathology(ies) of each woman; 2. Weighting of her pathology(ies) by using the proportion of MIC/M beds of the maternity where the woman is treated; 3. Summing up this weighted coefficients by pathology to create a "MIC-bedsweighed index” by pathology. Afterwards, this index was assigned to each pathology of each woman. These indexed pathologies were then summed by woman and by maternity so that each maternity received a weighed score indicating the hospital-specific load of those pathologies that are more likely to be encountered in MIC-services. This score of the maternities was afterwards compared with the percentage of women theoretically requiring intermediate care in each maternity. The correlation between the observed and theoretical score has been displayed graphically in a scatter plot. Figure 15: Correlation between the observed and theoretical score Source: Merged IMA and MKG/RCM Data 01/10/2003 – 30/09/2004 According to the performance of the model, there is a good correlation (y=0, 8417 x + 0.0178 R²=0.5291) between the observed and theoretical case-mix: maternity services that are more MIC-oriented receive a higher proportion of intermediate care women. It confirms moreover that the case-mix of the MIC-services is only moderately MICoriented.
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35. Etude relative aux coûts poten
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Soins maternels intensifs (Maternal Intensive Care) en Belgique - KCE

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