Geographic Distance Between Perinatal and Pediatric Palliative Care Services and Implications for Practice Standards

Area of Science:

• Healthcare Access and Delivery
• Geospatial Analysis in Healthcare
• Palliative Care Research

Background:

• Current practice standards advocate for early integration of perinatal and pediatric palliative care (PC).
• Seamless transitions of care across different settings are recommended.
• Limited data exists on the national proximity of these specialized services.

Purpose of the Study:

• To investigate geospatial variations between perinatal and pediatric palliative care services nationwide.
• To analyze the proximity of perinatal PC programs to pediatric PC physicians.
• To calculate infant mortality rates relative to perinatal PC programs.

Main Methods:

• Utilized data from the National Plan and Provider Enumeration System (NPPES).
• Incorporated a publicly available directory of perinatal PC programs.
• Conducted geospatial analysis to determine service proximity and calculated infant mortality rates.

Main Results:

• Identified 418 pediatric PC physicians and 296 perinatal PC programs.
• Found significant geographic disparities, with high concentrations of pediatric PC physicians in five states and none in five others.
• Perinatal PC programs were widely dispersed, with substantial median drive times (up to 5 hours) to pediatric PC physicians in some states.

Conclusions:

• Significant distances between perinatal and pediatric palliative care services were observed nationally.
• These findings highlight potential challenges in care coordination and patient outcomes.
• Further research into partnerships and the implications of these distances on patient care is warranted.