Therapeutic alternatives in neonatology: towards a reduction of the cost of prematurity

Abstract

The development of new technologies and therapies has encumbered the practice of neonatal medicine. While modern neonatology is widespread throughout the industrialized countries it remains available to only a relatively small segment of populations in developing countries. A strategy must therefore be developed to save young lives in these latter settings. Real operational changes will be required in the existing health care systems. Cost/benefit considerations need to be introduced into the everyday practice of neonatology in order to help practitioners better manage health care and not simply be punctual therapists. Both prevention of disease and the rational application of health care services are needed. Toward that end the author encourages the practice of a less onerous form of neonatal medicine. The author s experience is drawn from 146 cases of premature infants born at 27-32 weeks gestation admitted to the neonatology service of the Saint-Georges Hospital in Beirut Lebanon between January 1996 and November 1998. Physicians need to be encouraged to practice their art responsibly independently of both institutional and personal interests.