Barriers to Transportation: A Study on Patients with End-Stage Renal Disease Receiving in-Center Hemodialysis

Abstract

Without kidney transplant, treatment for end-stage renal disease is considered lifelong. Non-emergency medical transportation through Medicaid and the complementary paratransit services under the Americans with Disabilities Act 1990, were identified as the two major sources of transportation services for end-stage renal disease patients. The purpose of the study was to explore barriers to transportation experienced by dialysis patients using transportation services for in-center dialysis and transplant related medical appointments. The study used a non-experimental quantitative research design to explore the barriers and used web-based survey to collect the data. The link to the web-based survey was disseminated on National Kidney Foundation’s Facebook and online forum and the survey collected 231 responses. The results of the study indicated prevalence of barriers to transportation for patients with end-stage renal disease. The barriers pose a risk for shortening or missing dialysis appointments affecting dialysis patient’s health, leading to an increase in hospitalization and mortality rates. The findings of the study provided foundations for interventions and policy implications to diminish barriers to transportation for patients with end-stage renal disease. Future studies may address barriers to transportation based on end-stage disease patients’ physical limitations and at different geographic settings.

Keywords:

• barriers to transportation
• end-stage renal disease
• non-emergency medical transportation
• complementary paratransit transportation

Acknowledgements

The author express gratitude and appreciation to National Kidney Foundation (NKF) and Kelli Collins, Vice President for Patient Engagement with NKF, for the support and help in disseminating the Dialysis Transportation Survey on NKF’s Facebook and on NKF’s dialysis online community.