Abstract
Objective The objective of this investigation was to determine maternal ground transport times
from community hospitals to the nearest hospital offering comprehensive (level III)
neonatal care within the contiguous United States.
Study Design This observational study combined data from the 2010 U.S. Census tract and 2010 American
Hospital Association Annual Survey. Level III (full complement of care) neonatal centers
were plotted using 2010 geographical information systems (GIS) mapping software (ESRI,
Redland, California, United States). Locations of level I (uncomplicated care) and
level II (limited complicated care) centers and residences of reproductive-aged women
(18 to 39 years old) were mapped to identify maternal ground transport times to level
III centers.
Results Most of the 584 level III neonatal centers were located in metropolitan areas (83.5%).
The proportions of level I and level II hospitals within a 30-minute drive of a level
III neonatal center were 19.8 and 47.3%, and 52.2 and 69.8% were within a 60-minute
drive time. Ground transport times were shortest in the Northeast and metropolitan
areas, and longest in the rural Great Plains and noncoastal West.
Conclusion GIS mapping enables health providers and health policy makers to better understand
maternal ground transport times to current and future regional hospitals offering
level III neonatal services.
Keywords
comprehensive care - geographical information systems (GIS) - ground transport - health
care access - neonatal center