Proximity to risk-appropriate perinatal hospitals for pregnant women with congenital heart defects in New York state
Abstract Background Women with congenital heart defects (CHDs) experiencing pregnancies require specialized delivery care and extensive monitoring that may not be available at all birthing hospitals. In this study, we examined proximity to, and delivery at, a hospital with an appropriate level of pe...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | http://link.springer.com/article/10.1186/s12884-020-03025-4 |
| _version_ | 1818255853236518912 |
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| author | Lauren E. Schlichting Tabassum Insaf George Lui Ali Zaidi Alissa Van Zutphen |
| author_facet | Lauren E. Schlichting Tabassum Insaf George Lui Ali Zaidi Alissa Van Zutphen |
| author_sort | Lauren E. Schlichting |
| collection | DOAJ |
| description | Abstract Background Women with congenital heart defects (CHDs) experiencing pregnancies require specialized delivery care and extensive monitoring that may not be available at all birthing hospitals. In this study, we examined proximity to, and delivery at, a hospital with an appropriate level of perinatal care for pregnant women with CHDs and evaluated predictors of high travel distance to appropriate care. Appropriate care was defined as Level 3 perinatal hospitals and Regional Perinatal Centers (RPCs). Methods Inpatient delivery records for women with CHD in New York State (NYS) between 2008 and 2013 were obtained. Driving time and transit time were calculated between the pregnant woman’s residence and the actual delivery hospital as well as the closest Level 3 or RPC hospital using Geographic Information Systems (GIS). Linear and logistic regression models evaluated predictors of high distance to, and utilization of, appropriate delivery care respectively. Results From 2008 to 2013, there were 909 deliveries in a NYS hospital by women with CHDs. Approximately 75% of women delivered at a Level 3 or RPC hospital. Younger women, those who reside in rural and smaller urban areas, and those who are non-Hispanic White had a greater drive time to an appropriate care facility. After adjustment for geographic differences, racial/ethnic minorities and poor women were less likely to deliver at an appropriate delivery care center. Conclusions Although most women with CHDs in NYS receive appropriate delivery care, there are some geographic and socio-demographic differences that require attention to ensure equitable access. |
| first_indexed | 2024-12-12T17:18:27Z |
| format | Article |
| id | doaj.art-5681a86a6df24a0bb27e0cfa4193938b |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-12T17:18:27Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-5681a86a6df24a0bb27e0cfa4193938b2022-12-22T00:17:43ZengBMCBMC Pregnancy and Childbirth1471-23932020-06-0120111410.1186/s12884-020-03025-4Proximity to risk-appropriate perinatal hospitals for pregnant women with congenital heart defects in New York stateLauren E. Schlichting0Tabassum Insaf1George Lui2Ali Zaidi3Alissa Van Zutphen4Hassenfeld Child Health Innovation Institute, Brown UniversityBureau of Environmental and Occupational Epidemiology, New York State Department of HealthPediatric Cardiology and Cardiovascular Medicine, Lucile Packard Children’s Hospital StanfordAlbert Einstein College of MedicineBureau of Environmental and Occupational Epidemiology, New York State Department of HealthAbstract Background Women with congenital heart defects (CHDs) experiencing pregnancies require specialized delivery care and extensive monitoring that may not be available at all birthing hospitals. In this study, we examined proximity to, and delivery at, a hospital with an appropriate level of perinatal care for pregnant women with CHDs and evaluated predictors of high travel distance to appropriate care. Appropriate care was defined as Level 3 perinatal hospitals and Regional Perinatal Centers (RPCs). Methods Inpatient delivery records for women with CHD in New York State (NYS) between 2008 and 2013 were obtained. Driving time and transit time were calculated between the pregnant woman’s residence and the actual delivery hospital as well as the closest Level 3 or RPC hospital using Geographic Information Systems (GIS). Linear and logistic regression models evaluated predictors of high distance to, and utilization of, appropriate delivery care respectively. Results From 2008 to 2013, there were 909 deliveries in a NYS hospital by women with CHDs. Approximately 75% of women delivered at a Level 3 or RPC hospital. Younger women, those who reside in rural and smaller urban areas, and those who are non-Hispanic White had a greater drive time to an appropriate care facility. After adjustment for geographic differences, racial/ethnic minorities and poor women were less likely to deliver at an appropriate delivery care center. Conclusions Although most women with CHDs in NYS receive appropriate delivery care, there are some geographic and socio-demographic differences that require attention to ensure equitable access.http://link.springer.com/article/10.1186/s12884-020-03025-4Adult congenital heart diseasePregnancyAccess to careDisparitiesSpatial analysis |
| spellingShingle | Lauren E. Schlichting Tabassum Insaf George Lui Ali Zaidi Alissa Van Zutphen Proximity to risk-appropriate perinatal hospitals for pregnant women with congenital heart defects in New York state BMC Pregnancy and Childbirth Adult congenital heart disease Pregnancy Access to care Disparities Spatial analysis |
| title | Proximity to risk-appropriate perinatal hospitals for pregnant women with congenital heart defects in New York state |
| title_full | Proximity to risk-appropriate perinatal hospitals for pregnant women with congenital heart defects in New York state |
| title_fullStr | Proximity to risk-appropriate perinatal hospitals for pregnant women with congenital heart defects in New York state |
| title_full_unstemmed | Proximity to risk-appropriate perinatal hospitals for pregnant women with congenital heart defects in New York state |
| title_short | Proximity to risk-appropriate perinatal hospitals for pregnant women with congenital heart defects in New York state |
| title_sort | proximity to risk appropriate perinatal hospitals for pregnant women with congenital heart defects in new york state |
| topic | Adult congenital heart disease Pregnancy Access to care Disparities Spatial analysis |
| url | http://link.springer.com/article/10.1186/s12884-020-03025-4 |
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