Travel Time to Hospital for Childbirth: Comparing Calculated Versus Reported Travel Times in France

  • Hugo Pilkington
  • Caroline Prunet
  • Béatrice Blondel
  • Hélène Charreire
  • Evelyne Combier
  • Marc Le Vaillant
  • Jeanne-Marie Amat-Roze
  • Jennifer Zeitlin
Article
  • 34 Downloads

Abstract

Objectives Timely access to health care is critical in obstetrics. Yet obtaining reliable estimates of travel times to hospital for childbirth poses methodological challenges. We compared two measures of travel time, self-reported and calculated, to assess concordance and to identify determinants of long travel time to hospital for childbirth. Methods Data came from the 2010 French National Perinatal Survey, a national representative sample of births (N = 14 681). We compared both travel time measures by maternal, maternity unit and geographic characteristics in rural, peri-urban and urban areas. Logistic regression models were used to study factors associated with reported and calculated times ≥30 min. Cohen’s kappa coefficients were also calculated to estimate the agreement between reported and calculated times according to women’s characteristics. Results In urban areas, the proportion of women with travel times ≥30 min was higher when reported rather than calculated times were used (11.0 vs. 3.6%). Longer reported times were associated with non-French nationality [adjusted odds ratio (aOR) 1.3 (95% CI 1.0–1.7)] and inadequate prenatal care [aOR 1.5 (95% CI 1.2–2.0)], but not for calculated times. Concordance between the two measures was higher in peri-urban and rural areas (52.4 vs. 52.3% for rural areas). Delivery in a specialised level 2 or 3 maternity unit was a principal determinant of long reported and measured times in peri-urban and rural areas. Conclusions for Practice The level of agreement between reported and calculated times varies according to geographic context. Poor measurement of travel time in urban areas may mask problems in accessibility.

Keywords

Accessibility Travel time Hospital planning Perinatal care France 

Abbreviations

INSEE

National Institute for Statistics and Economic Studies

NPS

National Perinatal Survey

ZAUER

Zonage en aires urbaines et aires d’emploi de l’espace rural

Supplementary material

10995_2017_2359_MOESM1_ESM.docx (89 kb)
Supplementary material 1 (DOCX 88 KB)

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Hugo Pilkington
    • 1
  • Caroline Prunet
    • 2
  • Béatrice Blondel
    • 2
  • Hélène Charreire
    • 3
  • Evelyne Combier
    • 4
  • Marc Le Vaillant
    • 5
  • Jeanne-Marie Amat-Roze
    • 3
  • Jennifer Zeitlin
    • 2
  1. 1.Département de Géographie, Université Paris 8 Vincennes-Saint-Denis, UMR7533 LadyssSaint-DenisFrance
  2. 2.INSERM U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Research on Epidemiology and Statistics Sorbonne Paris Cité (CRESS)Paris Descartes UniversityParisFrance
  3. 3.Université Paris-Est, LabUrba, Ecole d’urbanisme de ParisCréteilFrance
  4. 4.Centre d’épidémiologie des populations (CEP)University of Burgundy, EA4184 CHU, Hôpital du BocageDijonFrance
  5. 5.Centre de Recherche, médecine, sciences, santé, santé mentale, société (CERMES3) INSERM U988 - CNRS UMR 8211Villejuif CedexFrance

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