S MCDONALD1,2,3, S ULLAH1,3, E DUNCANSON1, K DANSIE1, A GULYANI1, S JESUDASON1,2,3
1Anzdata Registry, Adelaide, Australia, 2Renal Unit, Royal Adelaide Hospital, Adelaide, Australia, 3University of Adelaide, Adelaide, Australia
Aim: To characterise the burden of travel to haemodialysis (HD) in metropolitan Australia.
Background: Travel to treatment has been identified as a significant burden for haemodialysis (HD) patients, but data on Australian-specific travel distance and time to HD is lacking.
Methods: Using data from ANZDATA and ABS, distance and travel time from the population centroid of residential postcode to treatment centre was estimated utilising OSRM routing algorithms for 5,831 Australian patients receiving facility HD (hospital or satellite) in major cities at 31 December 2016.
Results: Median one-way travel distance to patients’ actual treatment facility was 9.2 kilometres (interquartile range 5.1 to 15.2 km), with substantial variation between states (from 5.3 (ACT) to 12.6 (QLD) km, p<0.001). Median estimated travel time was 9.8 minutes (IQR 6.0-15.1 minutes), and greater for those in the first year of treatment (median 10.9 vs 8.9 km, p<0.001; 11.6 vs 9.5 minutes, p<0.001). Most patients (52%) received treatment at their closest facility. The additional travel burden was 5-9.9 km (for 25% of patients not treated at their closest facility), ≥10 km (31%), 10-19.9 minutes (18%), ≥20 minutes (8%). Among those not treated at their closest centre, 672 (71%) were receiving treatment in a hospital when the closest centre was a satellite and 659 (36%) were being treated at a satellite centre when the closest facility was a hospital.
Conclusions: Through novel application of cutting edge geospatial technology to the renal replacement population, this study provides insight into a previously suspected but un-measured aspect of patient experience. Facility HD patients in Australia have a substantial travel burden. Whether this is driven by clinical care needs or available HD capacity remains unknown.
Prof Stephen McDonald is Director of Dialysis at the Central Northern Adelaide Renal and Transplantation Service, Clinical Director of Renal Services for Country Health SA and Executive Officer of the Australia and New Zealand Dialysis and Transplant Registry. He also is a Clinical Professor in the Adelaide Medical School, and Principal Research Fellow in the SA Health and Medical Research institute (SAHMRI).