title: Geographical information systems for mapping maternal ground transport to level III care neonatal centers.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Departments of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
authors.forename: Steffen A
authors.initials: SA
authors.lastname: Brown
authors.affiliation: Emergency Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Richards
authors.affiliation: Departments of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
authors.forename: Erika C
authors.initials: EC
authors.lastname: Elwell
authors.affiliation: Departments of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
authors.forename: William F
authors.initials: WF
authors.lastname: Rayburn
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D040362:Geographic Information Systems; D062305:Geographic Mapping; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D011247:Pregnancy; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D013997:Time Factors; D014187:Transportation of Patients / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult