81 maternity units · 2018–2026

Newborns of at least 2.5 kg in Romanian hospitals: in 2025, 50 in 100 admissions were assigned “major problems” in the DRG groups, up from 29 in 2019

Every admission of a newborn weighing at least 2,500 g on admission, without an operating-theatre procedure, goes into a diagnosis-related group: “without problems”, “with other problems”, “with major problems” or “with multiple major problems”. Between 2019 and 2025, 17 per cent fewer cases were reported, and the share in the last two groups rose. At the Clinical County Emergency Hospital in Târgu Mureș it is 19 in 100, at the “Sf. Apostol Andrei” Clinical County Emergency Hospital in Galați 90. The share of cases under 2.5 kg on admission does not, on its own, explain the gap: it is higher at Târgu Mureș (20 per cent) than at Galați (12).

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Pick a unit in the chart or the search to see how its newborn cases are classified, year by year.

The four groups and the value of each#

The DRG system sorts admissions into groups by diagnosis and procedure, and each group has a relative value, a number of points reported for a case. For newborns weighing at least 2,500 g on admission and without an operating-theatre procedure there are four groups: “without problems” (0.3150 points), “with other problems” (0.7309), “with major problems” (1.3042) and “with multiple major problems” (2.2934). The relative value of a case in the last group is 7.3 times that of one in the first, and a case in “major problems” 4.1 times.

A case is an admission, not a child: a readmitted newborn appears twice. Newborns under 2,500 g have separate groups by weight band and are not counted here. Neither are those transferred or deceased within five days, nor those operated on. The relative values were the same in all nine periods, 2018–2026, so points change only through the number of cases and their spread across the groups.

The Romanian grouping manual defines a newborn’s “major problem” as at least one diagnosis from a table of major neonatal problems, and “multiple major problems” as at least two diagnoses from that same table. “With other problems” requires a diagnosis from a second table or a procedure from a list, and “without problems” is what remains for babies who meet none of those conditions. The code lists in these tables sit in a separate annex of the manual, in the edition hospitals use, and could not be checked here. The public tables therefore do not show which diagnoses moved cases from one group to another.

The share of cases with major problems has risen every year since 2022#

In 2019, 152,635 cases were reported, in 2025 126,798, 17 per cent fewer. “Without problems” fell from 31,420 to 16,734 cases (−46.7%), “with other problems” from 76,655 to 46,584 (−39.2%). “Major problems” rose from 39,498 to 53,696 (+35.9%), and “multiple major problems” almost doubled, from 5,062 to 9,784 (+93.3%).

The change is gradual, with no jump in one year: in 2018–2021 the share of cases with major or multiple major problems stayed between 28 and 30 per cent, then rose to 34 in 2022, 37 in 2023, 44 in 2024 and 50 in 2025. In the first nine months of 2026 it is 52.

In points, the 126,798 cases of 2025 correspond to 131,788 points. With the 2019 spread across the groups, applied to the same cases, it would be 107,203: 24,586 points more, or 23 per cent. The “major problems” and “multiple major problems” groups account for 70 in 100 of the points of the four groups. Points are not lei: the amount for a case is the relative value times the hospital’s tariff per weighted case, and tariffs differ (in the annex of 31 March 2025, from 1,599 to 2,465 lei in the examples given). At those two tariffs, 24,586 points come to between 39 and 61 million lei a year, an illustrative value. What was actually settled also depends on each hospital’s contract and cannot be calculated from these tables.

Multiple major problemsMajor problemsOther problemsWithout problems

Newborn cases of at least 2.5 kg by group, per 100 cases. Above: share with major or multiple major problems. *2026: January–September.

Between maternity units, the share runs from 3 to 97 in 100#

Of the 81 maternity units with at least 400 cases in 2025 and a newborn-case count close to their deliveries, 16 have more than 75 in 100 cases in the major-problem groups and 17 have under 25. Roughly one in ten is below 19, one in ten above 84. Among units with a caesarean rate between 50 and 70 per cent (33 hospitals), the share runs from 11 to 90.

Two county emergency hospitals illustrate the gap: the Clinical County Emergency Hospital in Târgu Mureș (19 in 100) and the “Sf. Apostol Andrei” Clinical County Emergency Hospital in Galați (90). The other county hospital in Târgu Mureș, Spitalul Clinic Județean Mureș, has 21. Of the reported newborn cases, those under 2.5 kg on admission account for 20 per cent at the first hospital and 12 per cent at the one in Galați. Those shares alone do not explain the difference between the two hospitals’ groups.

Six units are left out of the ranking because they count far more newborn cases than deliveries (Cantacuzino Hospital, Eiffel Med, Med Life, Medgidia Municipal Hospital, Roman Municipal Hospital, Sanador). The count may include readmissions or transfers from other hospitals, so their share is not directly comparable with the other units.

Units in the ranking, by share of cases with major or multiple major problems, 2025
Unit	Town	Newborn cases	Major or multiple, per 100	Caesareans, per 100 births
Euromaterna	Constanța	1,163	96.6	95
Spitalul Județean Clinic de Urgență Sf. Apostol Andrei Galați	Galați	967	89.6	60
Spitalul Universitar de Urgență Elias București	București	975	87.4	83
Spitalul Clinic Județean de Urgență Brăila	Brăila	1,271	86.9	63
Centrul Medical Unirea Brașov	Brașov	563	86.7	87
Spitalul Județean Buzău	Buzău	1,929	86.2	64
Spitalul Județean de Urgență Călărași	Călărași	583	84.6	73
Spitalul Clinic de Obstetrică-Ginecologie Prof. Dr. Panait Sîrbu București	București	3,137	84.4	78
Spitalul de Obstetrică Ginecologie Buftea	Buftea	646	83.0	75
Spitalul Clinic de Obstetrică-Ginecologie Elena Doamna Iași	Iași	1,086	83.0	69
Spitalul Județean de Urgență Dr. Constantin Opriș Baia Mare	Baia Mare	1,991	82.7	59
Spitalul Clinic de Urgență Sf. Pantelimon București	București	790	82.4	76
Spitalul Județean Pitești	Pitești	1,132	81.7	84
Spitalul Județean Deva	Deva	406	76.6	63
Spitalul Municipal de Urgență Moinești	Moinești	677	75.6	72
Spitalul Județean Clinic de Urgență Craiova	Craiova	1,718	75.3	58
Spitalul Municipal Odorheiu Secuiesc	Odorheiu Secuiesc	929	72.0	36
Spitalul Municipal Clinic Filantropia Craiova	Craiova	1,806	71.6	80
Spitalul Județean Clinic de Urgență Cluj-Napoca	Cluj-Napoca	3,132	68.9	58
Spitalul Municipal Fălticeni	Fălticeni	641	68.0	49
Spitalul Municipal Rădăuți	Rădăuți	1,291	67.5	32
Spitalul Clinic de Obstetrică-Ginecologie Cuza-Vodă Iași	Iași	4,476	64.7	63
Spitalul Județean Clinic de Urgență Pius Brînzeu Timișoara	Timișoara	3,155	64.7	63
Spitalul Județean Reșița	Reșița	523	64.6	44
Spitalul Municipal Clinic de Urgență Timișoara	Timișoara	759	63.2	80
Spitalul Județean Dr. Fogolyán Kristóf Sfântu Gheorghe	Sfântu Gheorghe	869	62.6	45
Spitalul Municipal Pașcani	Pașcani	420	62.1	49
Spitalul Județean de Urgență Mavromati Botoșani	Botoșani	1,930	62.0	53
Arcadia Hospital	Iași	786	59.3	88
Spitalul Municipal Mediaș	Mediaș	666	57.1	39
Spitalul Județean Alexandria	Alexandria	873	56.5	56
Spitalul Municipal de Urgență Elena Beldiman Bârlad	Bârlad	908	56.2	44
Medicover	București	1,074	55.9	83
Spitalul Clinic Județean de Urgență Oradea	Oradea	3,047	54.5	56
Spitalul Județean de Urgență Ploiești	Ploiești	2,364	53.2	61
Spitalul Județean Clinic de Urgență Arad	Arad	1,924	51.9	64
Spitalul Județean Drobeta-Turnu Severin	Drobeta-Turnu Severin	648	51.7	67
Spitalul General CF 2 București	București	550	51.3	89
Spitalul Clinic Județean Sibiu	Sibiu	2,154	50.9	59
Spitalul Județean Satu Mare	Satu Mare	1,340	50.2	43
Spitalul Clinic Nicolae Malaxa București	București	831	48.6	76
Spitalul Județean Târgu Jiu	Târgu Jiu	710	47.9	65
Spitalul Județean de Urgență Sf. Ioan cel Nou Suceava	Suceava	3,198	47.0	50
Spitalul Județean de Urgență Bacău	Bacău	2,415	45.1	60
Spitalul Municipal Sighetu Marmației	Sighetu Marmației	509	43.2	57
Clinica Sanovil	Bistrița	865	43.1	60
Spitalul Județean de Urgență Tulcea	Tulcea	600	41.8	53
Spitalul de Obstetrică-Ginecologie Bunavestire Galați	Galați	465	40.2	47
Spitalul Județean de Urgență Piatra-Neamț	Piatra Neamț	1,167	40.1	61
Spitalul Județean Târgoviște	Târgoviște	1,176	37.2	54
Materna Care	Timișoara	799	36.8	49
Spitalul Județean de Urgență Slobozia	Slobozia	747	36.4	43
Spitalul Municipal Dr. E. Nicoară Reghin	Reghin	485	34.8	38
Spitalul Județean Slatina	Slatina	965	33.1	62
Institutul Național pentru Sănătatea Mamei și Copilului Alessandrescu-Rusescu	București	2,109	31.3	77
Spitalul Clinic Județean de Urgență Constanța	Constanța	2,364	30.8	57
Spitalul Județean Bistrița	Bistrița	1,365	30.5	38
Spitalul Județean de Urgență Vaslui	Vaslui	1,025	30.0	36
Centrul Medical Unirea Cluj	Cluj-Napoca	1,101	28.1	75
Spitalul Clinic de Obstetrică-Ginecologie Dr. I. A. Sbârcea Brașov	Brașov	3,580	27.8	54
Spitalul Județean de Urgență Alba Iulia	Alba Iulia	779	26.7	69
Spitalul Județean Zalău	Zalău	1,365	25.9	43
Centrul Medical Unirea București	București	466	25.8	85
Spitalul Municipal Anton Cincu Tecuci	Tecuci	608	25.3	47
Spitalul Clinic Filantropia București	București	4,023	24.3	57
Spitalul Clinic de Urgență Sf. Ioan București	București	1,126	24.2	70
Spitalul Universitar de Urgență București	București	1,374	24.0	81
Spitalul Pelican Oradea	Oradea	609	23.8	87
Delta Health	București	2,482	23.1	82
Spitalul Municipal Onești	Onești	668	22.9	39
Euclid Oradea	Oradea	554	22.4	35
Spitalul Județean Sfinții Împărați Constantin și Elena Ilfov	București	629	21.1	91
Spitalul Clinic Județean Mureș	Târgu Mureș	1,389	20.6	40
Spitalul Județean Clinic de Urgență Târgu Mureș	Târgu Mureș	1,277	19.2	32
Spitalul Județean de Urgență Sf. Pantelimon Focșani	Focșani	1,340	17.8	33
Spitalul Județean de Urgență Râmnicu Vâlcea	Râmnicu Vâlcea	1,053	15.5	51
Isis Medical Center	Constanța	618	10.5	67
Spitalul Județean Miercurea Ciuc	Miercurea Ciuc	1,244	10.2	36
Spitalul Municipal Dr. Aurel Tulbure Făgăraș	Făgăraș	451	6.9	44
Clinica Polisano	Sibiu	562	4.1	71
Spitalul Orășenesc Târgu-Neamț	Târgu Neamț	421	3.3	48

What explains the differences: three explanations put to the test#

Before the calculation, three explanations were fixed, with the threshold at which each would count as supported. For every unit in the ranking, the 2025 share of cases with major problems was compared with three indicators from the same tables. All are rank correlations; intervals are 95%.

1. How births are coded. The share should rise with the share of vaginal births coded “with catastrophic or severe complications”, after accounting statistically for the caesarean rate and the share of low-weight newborns. Threshold: a correlation of at least +0.30 in 2025 and at least +0.25 between the 2019–2025 changes. Result: 0.09 in 2025 (78 units; interval: −0.17 to 0.33) and −0.01 between changes (67 units). Not supported.

2. The share of low-weight newborns. The share of cases with major problems should follow the share of newborns under 2.5 kg. Threshold: a correlation of at least +0.30 in 2025 or between changes. Result: 0.13 in 2025 (81 units; interval: −0.10 to 0.35) and −0.14 between changes (72 units). Not supported.

3. The caesarean rate (the same tables are used in the page on caesareans by maternity unit). Threshold: a correlation of at least +0.30 with the caesarean rate, while the correlation with how births are coded, after accounting for caesareans and weight, stays under +0.30. Result: 0.31 (81 units; interval: 0.07 to 0.52), so the threshold is met, narrowly, and the interval is wide. The explanation meets the fixed rule narrowly; the observed association is modest and the interval is wide. Even at similar caesarean rates, the share runs from 11 to 90 in 100.

The 2019 ranking partly resembles the 2025 one: the rank correlation is 0.54 (interval: 0.34 to 0.70, 72 units). The share rose in 61 of the 72 units present in both years, by 22.6 points on average. The public tables do not say why. Still untested are how the newborn’s record is completed, local protocols, and the receiving of newborns from other maternity units.

How long they stay#

The average length of stay in 2025 is 3.1 days in “without problems”, 3.7 in “other problems”, 4.0 in “major problems” and 6.0 in “multiple major problems”. Within the same unit, the average for “major problems” exceeds that of “without problems” by 0.9 days (median of 54 units) and equals 0.89 of the average stay for births, whose median is 4.5 days.

These averages do not show how many newborns were discharged on the same day as their mother. “Multiple major problems” has an average stay of 6.0 days and accounts for 7.7 in 100 cases nationwide.

What the tables do not show#

The public tables do not hold each newborn’s diagnoses, only the group the case ended up in. They do not show whether the classification is correct, or whether a hospital has become more careful in recording problems that were previously left out. A rise can come from more careful coding, from a change in which cases are sent to the hospital, or from real illness. These data cannot choose between them.

The figures are cases (admissions), not children, and “at least 2.5 kg” refers to weight on admission. The 2026 data cover January to September. The “major problems” group alone does not tell you your baby’s diagnosis or how serious the problem was. If you have questions about your baby’s record, ask the neonatologist.

Method#

The data are the hospital-by-hospital DRG morbidity tables published by INMSS for every year from 2018 to 30 September 2026 (full years from one or two cumulative periods). From them were taken cases, bed-days and relative value for groups P3081–P3084 (newborn of at least 2,500 g on admission, no operating-theatre procedure) and for deliveries (O1011–O1013, O1021, O1022, O3011–O3013). The 2019 and 2025 totals match the sum over hospitals.

The ranking includes units with at least 400 cases in P3081–P3084 in the year and a ratio of newborn cases to deliveries between 0.75 and 1.15. The tests are rank correlations (Spearman), each over the units for which its variables exist; intervals are bootstrap over units, 1,000 repetitions. The three explanations and their thresholds were written before the calculation, and each test’s sample was clarified after an independent check, without changing thresholds or verdicts.