Identifying Gaps in Access to Risk-Appropriate Maternal Care

Georgia Clinical & Translational Science Alliance

Motivation & Problem Description

The United States has extremely poor maternal outcomes for a high-income country, and many of these poor outcomes are preventable
>40% of high-risk pregnant people do not deliver in facilities with "risk-appropriate" equipment/specialists. When this happens, the chances of poor maternal outcomes is significantly higher
Maternal transport is a key part of a systems-level strategy to coordinate care among facilities to transport pregnant people from facilities without "risk-appropriate care" to a facility that has the right care for them.
Health systems and policymakers have limited visibility into whether high-risk pregnant patients are reaching facilities equipped to provide risk-appropriate care. Without this information, it is difficult to identify gaps in maternal care access and target investments effectively

Quantify how maternal transports are being used across a statewide healthcare system.
Identify geographic regions and hospital networks where access to risk-appropriate maternal care may be limited.
Evaluate whether maternal transport patterns align with regional care coordination policies.

Analyzed over 700,000 Georgia birth records spanning five years.
Developed network analytics methods to characterize referral and maternal transport patterns across hospitals.
Identified naturally occurring care coordination networks and compared them with planned regionalization structures.

Identified regions with elevated maternal transport rates that may indicate a lack of access to risk-appropriate maternal care.
Demonstrated how health system affiliations and geographic distance influence maternal transport decisions.
Generated evidence used by policymakers, public health agencies, and maternal health stakeholders to evaluate regionalized systems of care.
Featured in statewide media and public health forums, including the Atlanta Journal-Constitution and Georgia DPH Maternal Health ECHO series.