TY - JOUR
T1 - Geographic Access to Health Care Services
T2 - The Case of Maintenance Hemodialysis
AU - Smith, Marc D.
AU - Robson, Alan M.
AU - Woodward, Robert S.
AU - Michelman, Jeffrey E.
AU - Valerius, Thomas J.
AU - Hong, Barry A.
N1 - Funding Information:
This research was supported by a grant from the Missouri Kidney Program, Columbia, Mo.
PY - 1985
Y1 - 1985
N2 - A longitudinal study of the system for delivering maintenance hemodialysis services in St Louis, Missouri was conducted to determine the significance of geographic access in the selection and continued utilization of a treatment facility. Historically, center hemodialysis patients in this metropolitan area received care at four centrally located facilities. In 1981, two new, independent facilities were constructed; a satellite of an existing unit was opened in 1983. The data obtained in this study demonstrated that end-stage renal disease (ESRD) patients generally did not change their mode of maintenance therapy, their treatment facility, or the location of their personal residence. When such changes occurred, they were rarely precipitated by a desire to reduce travel time to treatment. Furthermore, the opportunity to improve geographic access by transferring to a closer unit was perceived by patients to be viable only if they could retain their physician. It was concluded, therefore, that travel time to treatment is a relatively unimportant aspect of the chronic care of center hemodialysis patients in a metropolitan area.
AB - A longitudinal study of the system for delivering maintenance hemodialysis services in St Louis, Missouri was conducted to determine the significance of geographic access in the selection and continued utilization of a treatment facility. Historically, center hemodialysis patients in this metropolitan area received care at four centrally located facilities. In 1981, two new, independent facilities were constructed; a satellite of an existing unit was opened in 1983. The data obtained in this study demonstrated that end-stage renal disease (ESRD) patients generally did not change their mode of maintenance therapy, their treatment facility, or the location of their personal residence. When such changes occurred, they were rarely precipitated by a desire to reduce travel time to treatment. Furthermore, the opportunity to improve geographic access by transferring to a closer unit was perceived by patients to be viable only if they could retain their physician. It was concluded, therefore, that travel time to treatment is a relatively unimportant aspect of the chronic care of center hemodialysis patients in a metropolitan area.
KW - Geographic access
KW - end-stage renal disease
KW - hemodialysis
KW - travel time
UR - http://www.scopus.com/inward/record.url?scp=0021965526&partnerID=8YFLogxK
U2 - 10.1016/S0272-6386(85)80130-X
DO - 10.1016/S0272-6386(85)80130-X
M3 - Article
C2 - 3966465
AN - SCOPUS:0021965526
SN - 0272-6386
VL - 5
SP - 19
EP - 26
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 1
ER -