Background and Aim To improve neonatal conditions in the South of Vietnam through mapping the conditions during inter-hospital transfer, revealing avoidable factors and unmasking cultural differences allowing action towards improvements.
Method A prospective and analytical cohort study was conducted at Pediatric Hospital #1 in HCM City, Vietnam. Data was collected through standardized questionnaires and during a set timeframe in a one-month period. Infants < 28 days or weighing < 2000 g, transferred from the south-half of Vietnam were included giving a total of 103 neonates representing 96 transfers.
Results A transfer > 120 min increased the risk of admission > 8 days in total (p= .027) and in NICU (p= .001). The infants most vulnerable to transfer were more frequently transferred by an ambulance equipped and escorted to handle emergency than the least vulnerable (p= .003). However, the transfers of intermediate quality (51.5%) had significantly worse outcomes (p= .007). 28.2% of the ambulances were adequately equipped to handle emergencies and none had monitoring equipment for neonates. All neonates were escorted by health personnel, though none had transport training and only 32% had appropriate qualifications. Initiated treatment was continued, but no new initiatives were taken.
Conclusion The inter-hospital transport is of good standard, all transfers being by ambulance, with medical accompaniment and some pre-assessment made. A long transfer still worsens the outcome of the neonates significantly. However, our study reveals factors, which can be improved prior to, during and following transfer. In order to succeed with new approaches, the cultural aspects must be acknowledged.