Optimizing blood resource allocation in Oklahoma: A geospatial analysis of available supply and potential networks of...

Blood transfusion is essential for surgical, obstetric, oncologic, and trauma care, but availability may be limited in rural settings. We quantified O-type red blood cell (RBC) availability, access times, and donor distribution across Oklahoma and surrounding areas in 2024.

Using Esri ArcGIS Pro, we evaluated rural hospitals in Oklahoma and adjacent regions supplied by Our Blood Institute (OBI) in 2024. Hospitals were categorized by critical access designation and O-type RBC inventory, distinguishing low-stock from resuscitation ready facilities (≤2 and ≥4 units, respectively). Primary outcomes were geographic variation in RBC inventories and drive times to the nearest hospital stocking ≥2 and ≥4 O-type units. The secondary outcome was donor distribution.

Among 106 rural OBI-supplied hospitals, 16 (15.1%) stocked <2 units O-type RBCs, and 23% of rural critical access hospitals stocked <4 units. Overall, 198,294 patients (2.9%) live >30 min from any hospital stocking O-type RBCs, and 275,341 (4.0%) from one stocking ≥4 units. Of 245,068 donors, 40.87% were O+ and 8.59% were O-, with clustering that left several low-stock rural areas with limited donor pools.

Most rural OBI-supplied hospitals maintained adequate O-type RBC inventories, but a clinically significant minority stocked ≤2 units, insufficient for even a single hemorrhaging patient. Geographic variation in inventory and donor distribution means hemorrhage location remains a determinant of transfusion access. These findings support using local inventory and donor data to inform regional blood allocation, and identify translation of geospatial data into distribution and preparedness strategies as a priority for future research.