Comparison of the outcome of transported neonates between two study periods in Tainan

Neonatal transport is an integral part of perinatal regionalization and the pattern could be affected by the policy of payment. This study evaluated the impact of National Health Insurance on the results of neonatal transport in the Tainan area. We collected regional data on the transported neonates obtained over two time periods. The first group (n=260) was collected between July 1991 and May 1992, and the second group (n=473) was collected between August 1997 and March 1999, three years after the implementation of National Health Insurance. The percentage of low-birth weight neonates transported was not different between the two periods (59.6% vs 59.1%). The frequency of endotracheal tube intubation performed by the transport team (41.3% vs 21%, p<0.01) was lower in the latter group. The incidence of hypothermia was similar between the two groups (20.7% vs 19.8%). The incidence of hypoglycemia (26.8% vs 13%, p<0.01), acidemia (35.3% vs 26%, p<0.01), infant mortality (19.7% vs 9.3%, p<0.01) and incidence of discharge against medical advise (4.2% vs 0.4%, p<0.01) decreased in the latter period. We conclude that the outcome of neonatal transport has improved and may be due to the establishment of a network of transportation and the implementation of National Health Insurance.