Abstract
Objectives: To assess reducing travel time to
perinatal care centers, and to examine whether
reducing travel time influences the neonatal
mortality rate (NMR).
Methods: The travel time from a population
centroid in each municipality to the nearest
perinatal care center was measured using the
Geographic Information System at two time points,
2002 and 2006. Areas with and without reductions
in travel time were compared for changes in the
NMR. The Difference-In-Difference Estimation was
used to examine whether the NMR decreased in
areas with reducing travel times.
Results: The median travel time was reduced from
66.99 minutes in 2002 to 39.09 minutes in 2006,
and the mean NMR decreased from 1.72 (2002)
to 1.33 (2006). The travel time showed great
disparities. Of the areas that in 2002 had travel
times longer than 60 minutes, by 2006 some areas
that had improved accessibility by reducing travel
time also had significant reductions in the NMR
compared with regions that did not reduce travel
time by 2006.
Conclusions: Reducing travel time to perinatal
care centers by reconsidering the location of such
centers is an effective strategy to reduce the NMR
in Japan.
