For a study, researchers sought to determine whether there were any links between the patient’s home and the delivery hospital’s driving distance and poor maternal and perinatal health outcomes.
With the exception of inpatient hospital transfers and improbable distances, we conducted a retrospective cohort research utilizing Pennsylvania birth data from 2011 to 2015 for live deliveries that occurred at 20 weeks or more of gestation. ArcGIS was used to determine the shortest driving distance between the patient’s home and the delivery hospital, which was then compared to a composite of bad maternal outcomes (such as blood transfusion, unanticipated surgery, ruptured uterus, unanticipated hysterectomy, or intensive care unit admission) and neonatal intensive care unit (NICU) admission. With a reference difference of 1 km from the delivery hospital, multivariable-adjusted Poisson models were used to predict relative risks with 95% CIs.
The number of birth records included was 662,245; the average driving distance to the hospital was 11.3 km (interquartile range 5.4–21.6 km). NICU admissions were 8.4% overall, and the composite maternal outcome rate was 0.6%. Increasing driving distance was significantly linked to higher adjusted risks for the maternal composite outcome (aRR 1.22, 95% CI 1.07-1.36 for 60 km; 1.36, 95% CI 1.19-1.53 for 70 km; and 1.53, 95% CI 1.31-1.75 for 80 km) and NICU admission (aRR 1.70, 95% CI 1.65-1.76 for 60 km; 1.96, 95% CI 1.90-2.02 for 70 km; and 2.25, 95% CI 2.18–2.33 for 80 km).
Distances to the delivery facility were linked to a higher probability of NICU admission and unfavorable mother outcomes. However, further research was needed to determine if the results were a reflection of problems with the delivery of healthcare or were merely a sign of socioeconomic deprivation.
