Kiani Behzad, Bagheri Nasser, Tara Ahmad, Hoseini Benyamin, Tara Mahmoud
Department of Biomedical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad.
Geospat Health. 2017 May 11;12(1):561. doi: 10.4081/gh.2017.561.
Chronic kidney disease is growing and the current estimated global prevalence exceeds 13%. As the use of haemodialysis machines for patients with end stage renal disease increases survival considerably, it is critical to plan correctly for the allocation of these machines. This study aimed to develop a geographical information systems (GIS)-based approach to predict the need for this service in the northeastern region of Iran taking into account where patients live and where haemodialysis is the most needed and identifying areas with poor access to haemodialysis centres. Patients were interviewed to obtain self-reported actual travel time and the inverse distance-weighting algorithm was used to determine access in each area. The prediction is based on the domestic growth rate for haemodialysis services and the estimated active hours of machine use for the next five years. We estimate that six new haemodialysis machines are required in northeastern Iran at the present time with 50 machines required over the next five years. Ashkhane City was identified to have the least access to haemodialysis centres in the study area. Our GIS-based model can be used to investigate not only the need for new haemodialysis machines but also to examine geographic disparities in the allocation of haemodialysis centres and to identify areas most in need of this service. It is important that policymakers consider both spatial and non-spatial dimensions of access to enable better allocation of haemodialysis services ensuring they are targeted to reach those in need.
慢性肾脏病的发病率正在上升，目前全球估计患病率超过13%。由于为终末期肾病患者使用血液透析机可显著提高生存率，因此正确规划这些机器的分配至关重要。本研究旨在开发一种基于地理信息系统（GIS）的方法，以预测伊朗东北部地区对这项服务的需求，同时考虑患者居住地点、血液透析最需要的地点，并识别那些难以获得血液透析中心服务的地区。对患者进行了访谈，以获取自我报告的实际出行时间，并使用反距离加权算法来确定每个地区的可及性。该预测基于血液透析服务的国内增长率以及未来五年机器的估计使用时长。我们估计，目前伊朗东北部需要6台新的血液透析机，未来五年需要50台。在研究区域内，发现阿什卡内市获得血液透析中心服务的机会最少。我们基于GIS的模型不仅可用于调查对新血液透析机的需求，还可用于研究血液透析中心分配中的地理差异，并识别最需要这项服务的地区。政策制定者考虑可及性的空间和非空间维度非常重要，以便更好地分配血液透析服务，确保服务能够惠及有需要的人群。
