Service Communautaire d'Information sur la Recherche et le Développement - CORDIS

Assessment of the current state of regionalization in Europe and the organizational factors which influence health outcomes for use in the evaluation of regional and national health policies

The MOSAIC project provides empirical high quality data on the current state of care for very preterm babies in Europe. Very preterm babies have better survival and lower mortality when they are born in a maternity with neonatal intensive care units and many countries have designated specialised perinatal units (often labeled level III unit) where these babies should be delivered. However, assessment of the care of these babies in most Europe countries is not possible because of the absence of comparable data. Furthermore, while there is widespread agreement about the negative impact of birth in a maternity unit with no neonatal intensive care on-site, there is no clear consensus about the key structural characteristics of a perinatal center. In particular, some studies have found that care in units with a lower volume of patients is associated with poor outcomes.

With respect to these important public health issues, the MOSAIC project provides information on:
- The place of birth of very preterm births in relation to the structural characteristics of the maternity and neonatal units; this provides a benchmark for assessing regionalisation of care in Europe in health systems with a large variability in organizational structure.

- The health outcomes of babies with respect to the different models of organization. In this project several models were able to obtain similar health outcomes for this high risk population. At the same time, the project identified organisational weaknesses, which exist in several different models of care, that are related to poor outcome.

These results are important for recognising that (1) European countries can attain common goals using different models of care and that (2) research on the organisation of care in these diverse models makes it possible to identify the characteristics of care that lead to poor outcome. This approach can be applied more generally to the organisation of health services in other health disciplines.

The project also described marked differences in the use of human and capital resources and in travel distances for users in the various systems; these data can be used to improve the efficiency of health care delivery.

END USERS OF THIS RESULT: Health policy makers seeking to improve the organisation of health care in their countries, European level bodies seeking to assess quality of perinatal health care among member states, regional governments modifying policy, professional societies seeking to elaborate guidelines, clinicians interested in contrasting their own results with those in other organisational contexts.

DISSEMINATION STRATEGY: Through presentations in scientific congresses and publications in the scientific press. Within the MOSAIC regions, advocacy work by the regional teams with respect to these results.

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