Factors associated with travel time and distance to access hospital care among children with spina bifida
Methods: This was a statewide, population-based study of Florida-born children with SB 1998-2007, identified by the Florida Birth Defects Registry and linked to hospitalizations. We geocoded maternal residence at delivery and identified hospital locations for infants (<1 year) and children ages 1-4 years. Using the Florida Department of Transportation 2007 road network, we calculated one-way travel time and distance to access hospital care. Using logistic regression (<30 minutes or miles, reference vs. >30 minutes or miles), we examined selected factors associated with travel time and distance, including presence of hydrocephalus and isolated (no other major birth defect) vs. non-isolated SB.
Results: Of 612 children, 85.8% lived in urban areas; 14.2% in rural areas. One-way mean (median) hospital travel time during infancy and ages 1-4 years were 45.1 (25.9) and 39.8 (22.7) minutes, respectively. Infants with non-isolated SB and hydrocephalus traveled the longest to access hospital care (mean: 60.8 minutes; median: 34.2 minutes). During infancy, non-isolated SB, lower maternal education, and rural residence were associated with lower likelihood of traveling ≤30 minutes to hospitals. For all children, maternal minority race/ethnicity was associated with greater likelihood of traveling ≤30 minutes.
Conclusions: Results suggest infants with non-isolated SB and hydrocephalus had long travel times. Birth defects registry data and GIS methods are useful for evaluating access to care.
Learning Areas:Provision of health care to the public
Public health or related research
Compare travel time and distance for accessing hospital care among children with spina bifida by the presence of hydrocephalus and type of spina bifida. Describe factors associated with travel time and distance to access hospital care for children with spina bifida.
Keyword(s): Birth Defects, Geographic Information Systems (GIS)
Qualified on the content I am responsible for because: I am an RN specializing in Maternal and Child Health. This research is a part of my doctoral research on children with birth defects.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.