Drive Times to Hospitals With Perinatal Care in the United States
Obstetrics and Gynecology
OBJECTIVE: To evaluate access to inpatient obstetric care, we determined the proportions of women of reproductive age who resided within 30-minute and 60minute 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
... y 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 obstet-ric workforce planning and policy-making in relation to accessing care.