ArticleBMC health services research2020
Effect of centralization on geographic accessibility of maternity hospitals in Finland.
Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Navigating the latent phase of labour: women's experiences within structural constraints - a qualitative study from Germany.BMC pregnancy and childbirth · 2026Article
- Designing a minimum-cost health system for countrywide universal coverage.Health systems (Basingstoke, England) · 2026Article
- Risk-Appropriate Childbirth Care Among Higher-Risk Pregnant Rural Residents.JAMA health forum · 2025Article
- Does the reduction in obstetric hospitals result in an unintended decreased in-hospital delivery utilisation? A causal multilevel analysis in China.BMJ public health · 2025Article
- Choosing a maternity hospital: a matter of travel distance or quality of care?Research in health services & regions · 2024Article
- Can we optimize locations of hospitals by minimizing the number of patients at risk?BMC health services research · 2023Article
- Accessibility of HIV Services in Philadelphia: Location-Allocation Analysis.American journal of preventive medicine · 2022Article
- Regionalization of neonatal care: benefits, barriers, and beyond.Journal of perinatology : official journal of the California Perinatal Association · 2022Review
- Disparities in Healthcare Services and Spatial Assessments of Mobile Health Clinics in the Border Regions of Thailand.International journal of environmental research and public health · 2021Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundIn the past two decades, the number of maternity hospitals in Finland has been reduced from 42 to 22. Notwithstanding the benefits of centralization for larger units in terms of increased safety, the closures will inevitably impair geographical accessibility of services.
methodsThis study aimed to employ a set of location-allocation methods to assess the potential impact on accessibility, should the number of maternity hospitals be reduced from 22 to 16. Accurate population grid data combined with road network and hospital facilities data is analyzed with three different location-allocation methods: straight, sequential and capacitated p-median.
resultsDepending on the method used to assess the impact of further reduction in the number of maternity hospitals, 0.6 to 2.7% of mothers would have more than a two-hour travel time to the nearest maternity hospital, while the corresponding figure is 0.5 in the current situation. The analyses highlight the areas where the number of births is low, but a maternity hospital is still important in terms of accessibility, and the areas where even one unit would be enough to take care of a considerable volume of births.
conclusionsEven if the reduction in the number of hospitals might not drastically harm accessibility at the level of the entire population, considerable changes in accessibility can occur for clients living close to a maternity hospital facing closure. As different location-allocation analyses can result in different configurations of hospitals, decision-makers should be aware of their differences to ensure adequate accessibility for clients, especially in remote, sparsely populated areas.
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