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

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.