Variation in neonatal care “may” be influence rates of retinopathy of prematurity in neonatal intensive care units in Rio de Janeiro, Brazil

Premature babies treated in neonatal care units (NICUs) face many health problems, including retinopathy of prematurity (ROP) which is one of the leading causes of blindness in children in industrialized and middle income countries.

In our initial analysis of NICUs in Rio de Janeiro, we found a correlation between labor intensity in NICUs and survival rates was 0.837 (p=0.06). We also found that changes in the number of nurses could increase survival rates by 6.5% per nurse at neo-natal care units with lower survival rates. Another factor contributing to lower survival rates is the number of working incubators. However, we found that better coordination and organization around the nursing staff can mitigate lower capital intensity.

Overall, we found a very strong benefit/cost ratio for ROP screening (a cost of about $500,000 as compared to benefits in the range of 5 – 8 million dollars. However, the task at hand is to determine the best screening and treatment modalities.

Since ROP is a risk factor for premature babies treated in NICUs, it is also important to analyze screening programs as part of the overall care of these babies. We found a strong and positive benefit to cost ratio for screening programs for ROP in Rio de Janeiro that could be expanded to other areas of Brazil. Based on the lifetime costs of blindness due to ROP and the costs of expanding a screening program, our results adds to the Vision 2020 objective of reducing preventable blindness in low and middle income countries.