A Survey on the Organization and Operation of Level II/III Neonatal Intensive Care Units in Greece: A Comparison Between 2004 and 2022
Background/Objectives: Limited data exist on the organization and operation of Level II/III Neonatal Intensive Care Units (NICUs) in Greece; this retrospective cross-sectional survey explored their structure and functioning in 2004 and 2022. Methods: A structured questionnaire was utilized, along wi...
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2025-01-01
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| author | Kosmas Sarafidis Nicoletta Iacovidou Eleftheria Hatzidaki Ilias Chatziioannidis Gabriel Dimitriou |
| author_facet | Kosmas Sarafidis Nicoletta Iacovidou Eleftheria Hatzidaki Ilias Chatziioannidis Gabriel Dimitriou |
| author_sort | Kosmas Sarafidis |
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| description | Background/Objectives: Limited data exist on the organization and operation of Level II/III Neonatal Intensive Care Units (NICUs) in Greece; this retrospective cross-sectional survey explored their structure and functioning in 2004 and 2022. Methods: A structured questionnaire was utilized, along with demographic and perinatal data obtained from the Hellenic Statistical Authority. Results: Between 2004 and 2022, live births decreased by 28%, while the prematurity rate rose from 6.96% to 11.87% (<i>p</i> < 0.001). Significant regional differences were observed in the number of NICUs (<i>p</i> = 0.033), live births (<i>p</i> < 0.001), and NICUs per 10,000 live births (<i>p</i> = 0.025). In this survey, data from 20 Level III NICUs in 2004 and 22 NICUs (one Level II) in 2022 were analyzed. NICU admissions increased by 16.1% (<i>p</i> = 0.389), while the rate of admitted neonates/1000 live births increased from 13.5 to 21.8 (<i>p</i> < 0.001). In 2022, premature infants constituted 40.2% of NICU admissions. The number of board-certified neonatologists increased by 21.8% between 2004 and 2022 (<i>p</i> = 0.795), along with a rise in the ratio of neonatologists per 10,000 live births (from 14.8 to 25, respectively, <i>p</i> < 0.001). Conversely, there was a significant 17.2% reduction in the nursing staff by 2022 (<i>p</i> = 0.034). The number of available NICU beds also increased during the study period. The ratio of ventilators to intensive care beds significantly improved (<i>p</i> < 0.001). In 2022, new treatment modalities, like therapeutic hypothermia, were introduced, and most NICUs reported offering long-term follow-up programs. Conclusions: This survey highlights significant advancements in Level II/III NICU infrastructure and care capabilities, while emphasizing demographic changes and a critical shortage of neonatal nursing staff. These factors should be carefully considered by health authorities in the development of future neonatal care strategic planning in the country. |
| format | Article |
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| institution | Kabale University |
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| spelling | doaj-art-c91308739d864d1d9475bcd12ed6f0a02025-01-24T13:27:14ZengMDPI AGChildren2227-90672025-01-011218510.3390/children12010085A Survey on the Organization and Operation of Level II/III Neonatal Intensive Care Units in Greece: A Comparison Between 2004 and 2022Kosmas Sarafidis0Nicoletta Iacovidou1Eleftheria Hatzidaki2Ilias Chatziioannidis3Gabriel Dimitriou41st Department of Neonatology and Neonatal Intensive Care, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Ippokrateion General Hospital, 54642 Thessaloniki, GreeceNeonatal Department, National and Kapodistrian University of Athens, Aretaeio Hospital, 11528 Athens, GreeceDepartment of Neonatology & NICU, Medical School, University of Crete, University Hospital of Heraklion, 71003 Heraklion, Greece1st Department of Neonatology and Neonatal Intensive Care, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Ippokrateion General Hospital, 54642 Thessaloniki, GreeceDepartment of Pediatrics, Patras Medical School, University of Patras, University Hospital of Patras, 26504 Patras, GreeceBackground/Objectives: Limited data exist on the organization and operation of Level II/III Neonatal Intensive Care Units (NICUs) in Greece; this retrospective cross-sectional survey explored their structure and functioning in 2004 and 2022. Methods: A structured questionnaire was utilized, along with demographic and perinatal data obtained from the Hellenic Statistical Authority. Results: Between 2004 and 2022, live births decreased by 28%, while the prematurity rate rose from 6.96% to 11.87% (<i>p</i> < 0.001). Significant regional differences were observed in the number of NICUs (<i>p</i> = 0.033), live births (<i>p</i> < 0.001), and NICUs per 10,000 live births (<i>p</i> = 0.025). In this survey, data from 20 Level III NICUs in 2004 and 22 NICUs (one Level II) in 2022 were analyzed. NICU admissions increased by 16.1% (<i>p</i> = 0.389), while the rate of admitted neonates/1000 live births increased from 13.5 to 21.8 (<i>p</i> < 0.001). In 2022, premature infants constituted 40.2% of NICU admissions. The number of board-certified neonatologists increased by 21.8% between 2004 and 2022 (<i>p</i> = 0.795), along with a rise in the ratio of neonatologists per 10,000 live births (from 14.8 to 25, respectively, <i>p</i> < 0.001). Conversely, there was a significant 17.2% reduction in the nursing staff by 2022 (<i>p</i> = 0.034). The number of available NICU beds also increased during the study period. The ratio of ventilators to intensive care beds significantly improved (<i>p</i> < 0.001). In 2022, new treatment modalities, like therapeutic hypothermia, were introduced, and most NICUs reported offering long-term follow-up programs. Conclusions: This survey highlights significant advancements in Level II/III NICU infrastructure and care capabilities, while emphasizing demographic changes and a critical shortage of neonatal nursing staff. These factors should be carefully considered by health authorities in the development of future neonatal care strategic planning in the country.https://www.mdpi.com/2227-9067/12/1/85neonateintensive carelevel of carehealth policyneonatal standards |
| spellingShingle | Kosmas Sarafidis Nicoletta Iacovidou Eleftheria Hatzidaki Ilias Chatziioannidis Gabriel Dimitriou A Survey on the Organization and Operation of Level II/III Neonatal Intensive Care Units in Greece: A Comparison Between 2004 and 2022 Children neonate intensive care level of care health policy neonatal standards |
| title | A Survey on the Organization and Operation of Level II/III Neonatal Intensive Care Units in Greece: A Comparison Between 2004 and 2022 |
| title_full | A Survey on the Organization and Operation of Level II/III Neonatal Intensive Care Units in Greece: A Comparison Between 2004 and 2022 |
| title_fullStr | A Survey on the Organization and Operation of Level II/III Neonatal Intensive Care Units in Greece: A Comparison Between 2004 and 2022 |
| title_full_unstemmed | A Survey on the Organization and Operation of Level II/III Neonatal Intensive Care Units in Greece: A Comparison Between 2004 and 2022 |
| title_short | A Survey on the Organization and Operation of Level II/III Neonatal Intensive Care Units in Greece: A Comparison Between 2004 and 2022 |
| title_sort | survey on the organization and operation of level ii iii neonatal intensive care units in greece a comparison between 2004 and 2022 |
| topic | neonate intensive care level of care health policy neonatal standards |
| url | https://www.mdpi.com/2227-9067/12/1/85 |
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