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Article

A Survey on the Organization and Operation of Level II/III Neonatal Intensive Care Units in Greece: A Comparison Between 2004 and 2022

by
Kosmas Sarafidis
1,*,
Nicoletta Iacovidou
2,
Eleftheria Hatzidaki
3,
Ilias Chatziioannidis
1 and
Gabriel Dimitriou
4
1
1st Department of Neonatology and Neonatal Intensive Care, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Ippokrateion General Hospital, 54642 Thessaloniki, Greece
2
Neonatal Department, National and Kapodistrian University of Athens, Aretaeio Hospital, 11528 Athens, Greece
3
Department of Neonatology & NICU, Medical School, University of Crete, University Hospital of Heraklion, 71003 Heraklion, Greece
4
Department of Pediatrics, Patras Medical School, University of Patras, University Hospital of Patras, 26504 Patras, Greece
*
Author to whom correspondence should be addressed.
Children 2025, 12(1), 85; https://doi.org/10.3390/children12010085
Submission received: 20 December 2024 / Revised: 2 January 2025 / Accepted: 9 January 2025 / Published: 13 January 2025
(This article belongs to the Special Issue Neonatal Morbidity: Current Advances, New Perspectives and Future Challenges)
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Abstract

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% (p < 0.001). Significant regional differences were observed in the number of NICUs (p = 0.033), live births (p < 0.001), and NICUs per 10,000 live births (p = 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% (p = 0.389), while the rate of admitted neonates/1000 live births increased from 13.5 to 21.8 (p < 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 (p = 0.795), along with a rise in the ratio of neonatologists per 10,000 live births (from 14.8 to 25, respectively, p < 0.001). Conversely, there was a significant 17.2% reduction in the nursing staff by 2022 (p = 0.034). The number of available NICU beds also increased during the study period. The ratio of ventilators to intensive care beds significantly improved (p < 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.
Keywords: neonate; intensive care; level of care; health policy; neonatal standards neonate; intensive care; level of care; health policy; neonatal standards

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MDPI and ACS Style

Sarafidis, K.; Iacovidou, N.; Hatzidaki, E.; Chatziioannidis, I.; Dimitriou, G. A Survey on the Organization and Operation of Level II/III Neonatal Intensive Care Units in Greece: A Comparison Between 2004 and 2022. Children 2025, 12, 85. https://doi.org/10.3390/children12010085

AMA Style

Sarafidis K, Iacovidou N, Hatzidaki E, Chatziioannidis I, Dimitriou G. A Survey on the Organization and Operation of Level II/III Neonatal Intensive Care Units in Greece: A Comparison Between 2004 and 2022. Children. 2025; 12(1):85. https://doi.org/10.3390/children12010085

Chicago/Turabian Style

Sarafidis, Kosmas, Nicoletta Iacovidou, Eleftheria Hatzidaki, Ilias Chatziioannidis, and Gabriel Dimitriou. 2025. "A Survey on the Organization and Operation of Level II/III Neonatal Intensive Care Units in Greece: A Comparison Between 2004 and 2022" Children 12, no. 1: 85. https://doi.org/10.3390/children12010085

APA Style

Sarafidis, K., Iacovidou, N., Hatzidaki, E., Chatziioannidis, I., & Dimitriou, G. (2025). A Survey on the Organization and Operation of Level II/III Neonatal Intensive Care Units in Greece: A Comparison Between 2004 and 2022. Children, 12(1), 85. https://doi.org/10.3390/children12010085

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