Hospitals and primary care of Valencia and Murcia are a pilot programme for the follow up of late preterm infants.

-The hospital admission of a premature late less than a year by bronchiolitis multiplies by two health care costs in comparison with a baby to term

Madrid, 2011-July from five years ago, the working group led by Dr. Vicente RoquésHead of the faith of Valencia Hospital Neonatology Service develops a multidisciplinary meeting to update the concerns of practitioners in relation to the approach of the premature infant. During the meeting last Wednesday in Valencia, this group has put in common the need of care and improving the monitoring of the late preterm so-called, babies born between week 34 and 37 of preterm gestation representing almost 8% of all premature babies in the Valencian Community and more than 8% in Murcia.

The day with representatives of more than 30 hospitals in the Levant and Murcia has done a review of the management intra and extra Hospital of these late preterm infants. In recent years, one of the major concerns that draws the attention of Neonatologists is neurological development and the possible deficit can present in the long term. In this regard, Dr. Vicente Roqués has commented that is going to review the problems during and after hospitalization, presenting a pilot project together with the pediatricians of primary health care, for monitoring and early detection of the consequences arising from its birth before term with which you intend to reduce morbidity associated with their immaturity as well as the later sequels ”.

In the words of Dr. Roqués, for the implementation of this follow-up is necessary first and foremost appreciate measure the problems of these children in the first days of life and the increased incidence of respiratory, metabolic problems, hypothermia, jaundice, and feeding problems that may occuradapting the necessary additional resources, taking into account their increased health spending. Secondly there evolutionary follow-up to ensure the early detection of problems in its development. Hospitals that can not offer this follow-up must be coordinated with health centers to ensure it ”.

Pilot project

The system of operation of this pilot project is expected to be very simple. Late preterm infants are referred to their pediatricians with a comprehensive and cited report preferably within 72 hours after discharge. Then continue to the health of any child controls and a specific assessment of neurodevelopmental will be added to the six, twelve to eighteen months, which will be sent to the hospital. 24 Months, the hospital will make a final assessment with specific test of their psychomotor development. At all times your pediatrician will be in connection with the hospital to derive the child in case of need.

During the meeting, the Working Group has discussed way of intercommunication for the transfer data between primary care and Hospital, which should be as simple and effective, looking for tailor-made solutions for each hospital and its circumstances. The problem is different depending on the number of late preterm births or the possibility of coordination with the pediatricians of the health centres in your area. For Dr. Roqués, one of the advantages of this program is that he ensures a systematic and complete control of late preterm children without increasing the workload of the pediatrician sentences as the hospital ”.

Health expenditure

Dr. Roqués has also explained that the late preterm calls are defined by the scientific societies as a risk group for respiratory infections, mainly by the Respiratory Syncytial Virus (RSV). In this sense, the majority of hospitalizations occur by bronchiolitis caused by this virus, because they are more prone to infection because they are more immature lung structure and your immune system.

Length of hospitalization and the requirements of admission to intensive care units is greater than in a child to term. A recent study published in Journal of Medical Economics (2010), assessed the costs of hospitalization for VRS in preterm infants were: the hospital admission of a premature late less than a year by VRS generates a cost of 14.442 euros, while a child to term generates a cost of 6,865 euros ”.

Working Group

30 hospitals belonging to the Levant and Murcia are involved in the development of this group, who since 2008 has been developing a network of Spain, inside the Hera project pioneered. For this group, Vicente Roqués, responsible for when five years ago we raised the need for improved care at hospitals in our communities, regardless of their greater or lesser complexity, the answer was unanimous and we have witnessed a remarkable improvement in care focused on the development of the child and his familyboth in the environment and facilities so that families can relate to her son and the professionals who care for ”.