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Revealed access to haemodialysis facilities in northeastern Iran: Factors that matter in rural and urban areas

Behzad Kiani, Nasser Bagheri, Ahmad Tara, Benyamin Hoseini, Hamed Tabesh, Mahmood Tara
  • Behzad Kiani
    Department of Medical Informatics, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of
  • Nasser Bagheri
    Department of Health Services Research and Policy, College of Health and Medicine, Biology and Environment, Australian National University, Canberra, 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
  • Hamed Tabesh
    Department of Medical Informatics, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of
  • Mahmood Tara
    Department of Medical Informatics, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of | smtara@gmail.com

Abstract

Poor access to haemodialysis facilities is associated with high mortality and morbidity rates. This study investigated factors affecting revealed access to the haemodialysis facilities considering patients living in rural and urban areas without any haemodialysis facility (Group A) and those living urban areas with haemodialysis facilities (Group B). This study is based on selfreported Actual Access Time (AAT) to referred haemodialysis facilities and other information regarding travel to haemodialysis facilities from patients. All significant variables on univariate analysis were entered into a univariate general linear model in order to identify factors associated with AAT. Both spatial (driving time and distance) and non-spatial factors (sex, income level, caregivers, transportation mode, education level, ethnicity and personal vehicle ownership) influenced the revealed access identified in Group A. The non-spatial factors for Group B patients were the same as for Group A, but no spatial factor was identified in Group B. It was found that accessibility is strongly underestimated when driving time is chosen as accessibility measure to haemodialysis facilities. Analysis of revealed access determinants provides policymakers with an appropriate decision base for making appropriate decisions and finding solutions to decrease the access time for patients under haemodialysis therapy. Driving time alone is not a good proxy for measuring access to haemodialysis facilities as there are many other potential obstacles, such as women's special travel problems, poor other transportation possibilities, ethnicity disparities, low education levels, low caregiver status and low-income.

Keywords

Accessibility; Haemodialysis; Potential access; Revealed access; Iran

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Submitted: 2017-05-11 18:39:10
Published: 2017-11-07 10:36:13
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Copyright (c) 2017 Behzad Kiani, Nasser Bagheri, Ahmad Tara, Benyamin Hoseini, Hamed Tabesh, Mahmood Tara

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