Journal ArticleDOI
Geographic disparities in patient travel for dialysis in the United States
J. Mark Stephens,Samuel Brotherton,Stephan Dunning,Larry C. Emerson,David T. Gilbertson,David J. Harrison,John Kochevar,Ann McClellan,William M. McClellan,Shaowei Wan,Matthew Gitlin +10 more
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TLDR
Rural patients travel much longer distances for dialysis than urban patients, and accessing alternative facilities, if required, would greatly increase rural patient travel, while having little impact on urban patients.Abstract:
Purpose
To estimate travel distance and time for US hemodialysis patients and to compare travel of rural versus urban patients.
Methods
Dialysis patient residences were estimated from ZIP code-level patient counts as of February 2011 allocated within the ZIP code proportional to census tract-level population, obtained from the 2010 US Census. Dialysis facility addresses were obtained from Medicare public-use files. Patients were assigned to an “original” and “replacement” facility, assuming patients used the facility closest to home and would select the next closest facility as a replacement, if a replacement facility was required. Driving distances and times were calculated between patient residences and facility locations using GIS software.
Findings
The mean one-way driving distance to the original facility was 7.9 miles; for rural patients average distances were 2.5 times farther than for urban patients (15.9 vs 6.2 miles). Mean driving distance to a replacement facility was 10.6 miles, with rural patients traveling on average 4 times farther than urban patients to a replacement facility (28.8 vs 6.8 miles).
Conclusion
Rural patients travel much longer distances for dialysis than urban patients. Accessing alternative facilities, if required, would greatly increase rural patient travel, while having little impact on urban patients. Increased travel could have clinical implications as longer travel is associated with increased mortality and decreased quality of life.read more
Citations
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Journal ArticleDOI
The Economic Burden of Chronic Kidney Disease and End-Stage Renal Disease
Virginia Wang,Virginia Wang,Helene Vilme,Matthew L. Maciejewski,Matthew L. Maciejewski,L. Ebony Boulware +5 more
TL;DR: There is significant variability in the evidence about direct and indirect costs attributable to CKD and end-stage renal disease, with the most complete evidence concentrated on direct health care costs of patients with advanced to end-Stage CKD.
Journal ArticleDOI
Pharmacy-based methadone dispensing and drive time to methadone treatment in five states within the United States: A cross-sectional study.
Paul J. Joudrey,Nicholas Chadi,Payel Jhoom Roy,Kenneth L. Morford,Paxton Bach,Simeon D. Kimmel,Emily A. Wang,Susan L. Calcaterra +7 more
TL;DR: Rural census tracts have disproportionately long drive times to OTPs, drawing from policies to increase methadone access in countries like Canada and Australia, this geographic methad one disparity could be mitigated through implementation of pharmacy-based methamphetamineadone dispensing.
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Telemedicine and primary care obesity management in rural areas – innovative approach for older adults?
TL;DR: The use of Telemedicine has successfully been implemented in other specialties and could be a useful modality in delivering much needed intensive behavioral therapy, particularly in distant, under-resourced environments.
Journal ArticleDOI
Structural barriers to comprehensive, coordinated HIV care: geographic accessibility in the US South.
April D. Kimmel,Steven P. Masiano,Rose S Bono,Erika G. Martin,Faye Z. Belgrave,Adaora A. Adimora,Bassam Dahman,Hadiza Galadima,Hadiza Galadima,Lindsay M. Sabik,Lindsay M. Sabik +10 more
TL;DR: Geographic accessibility to comprehensive, coordinated HIV care (HIVCCC) in the US South is inadequate, even in high HIV burden areas, and geographic and racial/ethnic disparities exist.
Journal ArticleDOI
Proximity Does Not Equal Access: Racial Disparities in Access to High Quality Dialysis Facilities
TL;DR: African-Americans’ proximity to high-quality facilities does not lead to receiving care there, and institutional and social barriers may also play an important role in where people receive dialysis.
References
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Journal ArticleDOI
The Effects of Geography and Spatial Behavior on Health Care Utilization among the Residents of a Rural Region
Thomas A. Arcury,Wilbert M. Gesler,John S. Preisser,Jill E. Sherman,John Spencer,Jamie Perin +5 more
TL;DR: Several geographic and spatial behavior factors, including having a driver's license, use of provided rides, and distance for regular care, were significantly related to health care utilization for regular check-up and chronic care in the bivariate analysis.
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GIS and health care.
TL;DR: This review discusses recent literature on GIS and health care and considers the use of GIS in analyzing health care need, access, and utilization; in planning and evaluating service locations; and in spatial decision support for health care delivery.
Journal ArticleDOI
Geographic Access to Health Care for Rural Medicare Beneficiaries
TL;DR: The results suggest that most rural residents do not rely on urban areas for much of their care, particularly true for rural residents with specific diagnoses or those undergoing specific procedures.
Journal ArticleDOI
A methodological review of how heterogeneity has been examined in systematic reviews of diagnostic test accuracy
TL;DR: The emphasis on pooling individual aspects of diagnostic test performance and the under-use of statistical tests and graphical approaches to identify heterogeneity perhaps reflect the uncertainty in the most appropriate methods to use and also greater familiarity with more traditional indices of test accuracy.
Journal ArticleDOI
Distance and health care utilization among the rural elderly
TL;DR: Although the results confirm the idea that increased distance from provider does reduce utilization, they strongly suggest that distance to provider is a surrogate for location in a richer web of relations between residents and their local communities.