OBJECTIVE: To evaluate access to inpatient obstetric care, we determined the proportions of women of reproductive age who resided within 30-minute and 60-minute driving times to the nearest hospital offering perinatal services.
METHODS: Perinatal centers, identified from the 2007 American Hospital Association survey, were designated as being level I (uncomplicated obstetric and nursery care), level II (limited complicated care), or level III (full complement of care). The study population consisted of all reproductive-aged (18–39 years) women included in the 2010 U.S. Census Bureau estimates. We used geographic information system mapping software to map 30-minute and 60-minute drive times from the census block group centroid to the nearest perinatal center.
RESULTS: A total of 2,606 hospitals in the United States offered some level of perinatal care for the 49.8 million reproductive-aged women. Access to perinatal centers within a 30-minute drive varied by the level of care: 87.5% of the population to any center; 78.6% to level II or level III centers; and 60.8% to level III facilities. Access to the centers within a 60-minute drive also varied: 97.3% of the population to any center; 93.1% to level II or level III centers; and 80.1% to level III facilities. The mostly rural western half of the United States (except for the Pacific Coast) and Alaska had the greatest geographic maldistribution of perinatal services.
CONCLUSION: Driving times to hospitals offering perinatal care vary considerably. Using geographic information system software can be valuable for regional obstetric workforce planning and policy-making in relation to accessing care.
LEVEL OF EVIDENCE: III
Geographic-information software, used to determine drive times to hospitals offering perinatal services, can be instructive in policy-making about accessing obstetric care.
From the Departments of Obstetrics and Gynecology and Emergency Medicine, University of New Mexico, Albuquerque, New Mexico.
Corresponding author: William F. Rayburn, MD, MBA, University of New Mexico School of Medicine, Department of Obstetrics and Gynecology, MSC10 5580, 1 University of New Mexico, Albuquerque NM 87131-0001; e-mail: firstname.lastname@example.org.
Financial Disclosure The authors did not report any potential conflict of interest.