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

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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.

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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

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Funding

Grant from the French Institute for Public Health Research programme “Territories and Health 2008”. This source of funding had no involvement in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

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Authors and Affiliations

  1. Département de Géographie, Université Paris 8 Vincennes-Saint-Denis, UMR7533 Ladyss, 2 rue de la Liberté, 93526, Saint-Denis, France

    Hugo Pilkington

  2. INSERM U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Research on Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris Descartes University, Paris, France

    Caroline Prunet, Béatrice Blondel & Jennifer Zeitlin

  3. Université Paris-Est, LabUrba, Ecole d’urbanisme de Paris, Créteil, France

    Hélène Charreire & Jeanne-Marie Amat-Roze

  4. Centre d’épidémiologie des populations (CEP), University of Burgundy, EA4184 CHU, Hôpital du Bocage, Dijon, France

    Evelyne Combier

  5. Centre de Recherche, médecine, sciences, santé, santé mentale, société (CERMES3) INSERM U988 - CNRS UMR 8211, Villejuif Cedex, France

    Marc Le Vaillant

Authors
  1. Hugo Pilkington
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  2. Caroline Prunet
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  3. Béatrice Blondel
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  4. Hélène Charreire
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  5. Evelyne Combier
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  6. Marc Le Vaillant
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  7. Jeanne-Marie Amat-Roze
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  8. Jennifer Zeitlin
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Correspondence to Hugo Pilkington.

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No conflict of interest for any of the contributors.

Ethical Approval

The National Council on Statistical Information (Comité du Label) and the French Commission on Information Technology and Liberties (CNIL) approved this survey (Registration No. 909003).

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Pilkington, H., Prunet, C., Blondel, B. et al. Travel Time to Hospital for Childbirth: Comparing Calculated Versus Reported Travel Times in France. Matern Child Health J 22, 101–110 (2018). https://doi.org/10.1007/s10995-017-2359-z

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  • DOI: https://doi.org/10.1007/s10995-017-2359-z

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