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Kidney Week

Abstract: TH-PO234

Hemodialysis Transportation, Compliance, and Quality of Life

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Borshchenko, Yevgeniy, NYU Winthrop Hospital, Mineola, New York, United States
  • Tharian, Antonia, NYU Winthrop Hospital, Mineola, New York, United States
  • Drakakis, James, NYU Winthrop Hospital, Mineola, New York, United States
  • Masani, Naveed N., NYU Winthrop Hospital, Mineola, New York, United States
  • Khatri, Minesh, NYU Winthrop Hospital, Mineola, New York, United States
  • Grant, Candace D., NYU Winthrop Hospital, Mineola, New York, United States
Background

A common reason for nonadherence to hemodialysis (HD) treatments is difficulty with transportation. This difficulty can also be the catalyst for mental stress surrounding getting to the dialysis unit on time. Health disparities reflect social, economic, and/or environmental disadvantages. As modality used for transportation is dependent on a patient’s socioeconomic status, it can be related to health disparities. Identifying how transportation modality affects adherence to HD regiments and a patients perceieved quality of life can hopefully lead to improved strategies in HD transportation and improve clinical outcomes for all HD patients. We examined transportation modality, HD treatment compliance and its relationship with quality of life.

Methods

We reviewed the electronic charts of patients enrolled at our large hospital based non-profit dialysis network. We identified eligible patients that had documented transportation modality and Kidney Disease and Quality of Life (KDQOL-36) scores as well as health insurance information. HD compliance was calculated for the group between April 2014 to April 2018.The modes of transportation were designated as self/family (SF), ambulance/ambulette (AMB) and Taxi/AbleRide (TX). Health insurance was divided into three groups: Medicare (MCR), Medicaid (MCD) and private insurance/self-pay (PVT).

Results

The study population (n=249) was 46% white, 60% male, and had a median age of 62 years. The average compliance for the group was 91.6% with 76% of the patients at or above 90% compliance. 60%, 15% and 25% of the patients had MCR, MCD, or PVT insurance respectively. HD compliance by primary insurance varied at 93.3%, 92.14%, and 86.46%, for PVT, MCR and MCD, respectively (P<0.01). The average compliance was 92.7%, 90.8%, and 87.8% for travel by SF, AMB, and TX, respectively. There was a significant difference in the MCS component of the KDQOL-36 amoung the different modes of transportation with 48.4±10.4, 49.8±9.5, and 52.5±9.6, for travel by AMB, TX, and SF, respectively (p<0.02).

Conclusion

Our findings suggest that health insurance and transportation modality plays a significant role in hemodialysis treatment compliance.Transportation modatlity also plays a significant role in the mental health component of the KDQOL survey. Further prospective studies are required to confirm these relationships.