Comparing potential spatial access with self-reported travel times and cost analysis to haemodialysis facilities in North-eastern Iran

  • Behzad Kiani Vascular and Endovascular Surgery Research Center; Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of.
  • Nasser Bagheri Department of Health Services Research and Policy, College of Health and Medicine, Australian National University, Canberra, ACT, Australia.
  • Ahmad Tara Department of Nephrology, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of.
  • Benyamin Hoseini Department of Health Information Technology, Neyshabur University of Medical Sciences, Neyshabur, Iran, Islamic Republic of.
  • Soheil Hashtarkhani Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of.
  • Mahmood Tara | Taram@mums.ac.ir Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of.

Abstract

End-stage renal disease patients regularly need haemodialysis three times a week. Their poor access to haemodialysis facilities is significantly associated with a high mortality rate. The present cross-sectional study aimed to measure the potential spatial access to dialysis services at a small area level (census tract level) in North Khorasan Province, Iran. The patients were interviewed to obtain their travel information. The two-step floating catchment area (2SFCA) method was used to measure the spatial accessibility of patients to the dialysis centres. The capacity of the dialysis centre was defined as the number of active dialysis facilities in each centre and the haemodialysis patients in each area were considered as the users of dialysis services. The travel cost from each patient’s residence to the haemodialysis facilities was visualized by the Kriging interpolation algorithm in the study area. Spatial accessibility to the dialysis centre was poor in the northern part of the study area. Fortunately, there were not many haemodialysis patients in that area. Patients’ travel costs were high in the northern areas compared to the rest of study area. We observed a statistically significant reverse correlation between the self-reported travel time and computed spatial accessibility (-0.570, P value <0.01, two-tailed spearman test). This study supports the notion that the 2SFCA method could be associated with revealed access time to dialysis facilities, especially in low traffic and in flat areas such as northern Khorasan. The mapping of patients’ distribution and interpolated travel cost to the haemodialysis facilities could help policymakers to allocate health resources to the areas where the need is greater.

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Published
2018-11-09
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Original Articles
Keywords:
Driving cost, Haemodialysis, Kriging, Spatial accessibility, Travel time, Iran
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How to Cite
Kiani, B., Bagheri, N., Tara, A., Hoseini, B., Hashtarkhani, S., & Tara, M. (2018). Comparing potential spatial access with self-reported travel times and cost analysis to haemodialysis facilities in North-eastern Iran. Geospatial Health, 13(2). https://doi.org/10.4081/gh.2018.703

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