Inter-Hospital Transfer of Neonates in the South of Vietnam-Relations to Prognosis and Outcome: A Prospective Cohort Study

Malene Mie Andersen, Josefine

Abstract

Background: Neonatal mortality remains an important health issue worldwide. In Southern Vietnam, Pediatric Hospital Number 1 offers the highest level of neonatal care, wherefore interhospital transportation of newborns hereto is frequent. The conditions during this transportation are likely to influence the prognosis of the neonates. The aim of this study was to map the neonatal transfers, and hereby identify areas in which improvement could be made to further enhance neonatal survival in the south of Vietnam. Methods: A prospective cohort study was conducted at Pediatric Hospital No.1 in Ho Chi Minh City, Vietnam. During a one-month period, data was collected using standardized questionnaires on neonates transferred from the southern half of Vietnam. Results: A total of 103 neonates representing 96 transfers were included. All neonates were transferred by ambulance and escorted by health personnel. The transfers of intermediate quality (51.5%) had the highest mortality and a significantly longer hospitalization (p=0.007). Only 15.5% of the ambulances were adequately equipped to handle emergencies and few had monitoring equipment for neonates. Conclusion: The neonates with a high risk of needing resuscitation were transferred with a more sufficient equipped and accompanied transport, implying a pre-assessment was made. Though for more than half of the neonates, pre-assessment was insufficient leading to an inadequate transport and a worse outcome. Several areas can be improved to enhance the quality of transportation. Focus on training in neonatal transportation along with a clear definition of the functions and actions required of the accompaniment during transfer could be of great benefit.

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