Global estimates of access to health care treat every facility alike. Drive time was routed on the OpenStreetMap network from all 217,841 of its hospitals and 15-, 30- and 60-minute isochrones dissolved for nested capability tiers, weighted with GHS-POP 2025. 96.2% of the world's population lives within an hour's drive of a hospital, 78.5% of a hospital with a documented emergency department, and 40.3% of one with a helipad or university name marking tertiary care. The 1.45 billion people within an hour of a hospital but not of an emergency hospital live mainly in South and East Asia and Nigeria; the 312 million beyond an hour of any hospital lie in a belt from the Sahel to Madagascar. Defining the tertiary tier by helipad alone leaves its estimate unchanged, and the isochrone construction shifts the 60-minute figures by a few percent. Counting every facility as equivalent overstates access to time-critical care.

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