{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T10:25:25Z","timestamp":1788258325875,"version":"build-2803163510"},"reference-count":36,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T00:00:00Z","timestamp":1736726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Research Committee (Eidikos Logariasmos Kondylion Erevnas) of the Aristotle University of Thessaloniki"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>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 &lt; 0.001). Significant regional differences were observed in the number of NICUs (p = 0.033), live births (p &lt; 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 &lt; 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 &lt; 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 &lt; 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.<\/jats:p>","DOI":"10.3390\/children12010085","type":"journal-article","created":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T09:49:17Z","timestamp":1736761757000},"page":"85","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Survey on the Organization and Operation of Level II\/III Neonatal Intensive Care Units in Greece: A Comparison Between 2004 and 2022"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6806-6343","authenticated-orcid":false,"given":"Kosmas","family":"Sarafidis","sequence":"first","affiliation":[{"name":"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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoletta","family":"Iacovidou","sequence":"additional","affiliation":[{"name":"Neonatal Department, National and Kapodistrian University of Athens, Aretaeio Hospital, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6256-3309","authenticated-orcid":false,"given":"Eleftheria","family":"Hatzidaki","sequence":"additional","affiliation":[{"name":"Department of Neonatology & NICU, Medical School, University of Crete, University Hospital of Heraklion, 71003 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilias","family":"Chatziioannidis","sequence":"additional","affiliation":[{"name":"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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7929-1573","authenticated-orcid":false,"given":"Gabriel","family":"Dimitriou","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Patras Medical School, University of Patras, University Hospital of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e164396","DOI":"10.1001\/jamapediatrics.2016.4396","article-title":"Variation in Performance of Neonatal Intensive Care Units in the United States","volume":"171","author":"Horbar","year":"2017","journal-title":"JAMA Pediatr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e037135","DOI":"10.1136\/bmjopen-2020-037135","article-title":"Impact of Regionalisation and Case-Volume on Neonatal and Perinatal Mortality: An Umbrella Review","volume":"10","author":"Walther","year":"2020","journal-title":"BMJ Open"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Sarafidis, K., Chotas, W., Agakidou, E., Karagianni, P., and Drossou, V. 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