EVALUATION OF NEONATAL INTENSIVE-CARE TECHNOLOGIES

The development and dissemination of neonatal intensive care technolog y has been associated with improved survival for critically ill newbor n infants, particularly those with birth weights of less than 1,500 gr ams (3 pounds, 5 ounces). Despite these advances, there are concerns a bout the long-term health status of surviving infants and the costs of their initial and subsequent care. In this article, the authors revie w current evidence for the effectiveness of neonatal intensive care an d discuss several approaches to evaluating neonatal intensive care tec hnology. They discuss a four-step process originally proposed by Roper for assessing and improving neonatal intensive care practices which i ncludes (1) monitoring of practices, outcomes, and costs; (2) analysis of variation in practices, outcomes, and costs; (3) assessment of the efficacy of individual interventions, and (4) feedback and education to alter clinical behavior. The authors conclude that organized networ ks of neonatal intensive care units can play a crucial role in this pr ocess.