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Published on: March 6, 2019

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

Radion Svynarenko1, Meaghann S Weaver2,3, Ambria Williams2,4

  • 1The University of Tennessee Knoxville College of Nursing, Knoxville, TN, USA.

The American Journal of Hospice & Palliative Care
|May 14, 2026
PubMed

Insights

Geographic disparities exist between perinatal and pediatric palliative care (PC) services in the US. Many perinatal PC programs lack proximity to pediatric PC physicians, impacting care coordination.

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.

Keywords:
Equityaccessgeomappinggeospatialmaternal and child healthperinatal palliative care

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