Kiani Behzad, Bagheri Nasser, Tara Ahmad, Hoseini Benyamin, Hashtarkhani Soheil, Tara Mahmood
Vascular and Endovascular Surgery Research Center; Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad.
Geospat Health. 2018 Nov 9;13(2). doi: 10.4081/gh.2018.703.
End-stage renal disease patients regularly need haemodialysis three times a week. Their poor access to haemodialysis facilities is significantly associated with a high mortality rate. The present cross-sectional study aimed to measure the potential spatial access to dialysis services at a small area level (census tract level) in North Khorasan Province, Iran. The patients were interviewed to obtain their travel information. The two-step floating catchment area (2SFCA) method was used to measure the spatial accessibility of patients to the dialysis centres. The capacity of the dialysis centre was defined as the number of active dialysis facilities in each centre and the haemodialysis patients in each area were considered as the users of dialysis services. The travel cost from each patient's residence to the haemodialysis facilities was visualized by the Kriging interpolation algorithm in the study area. Spatial accessibility to the dialysis centre was poor in the northern part of the study area. Fortunately, there were not many haemodialysis patients in that area. Patients' travel costs were high in the northern areas compared to the rest of study area. We observed a statistically significant reverse correlation between the self-reported travel time and computed spatial accessibility (-0.570, P value <0.01, two-tailed spearman test). This study supports the notion that the 2SFCA method could be associated with revealed access time to dialysis facilities, especially in low traffic and in flat areas such as northern Khorasan. The mapping of patients' distribution and interpolated travel cost to the haemodialysis facilities could help policymakers to allocate health resources to the areas where the need is greater.
终末期肾病患者通常每周需要进行三次血液透析。他们难以获得血液透析设施，这与高死亡率显著相关。本横断面研究旨在衡量伊朗呼罗珊省北部小区域（普查区层面）透析服务的潜在空间可及性。对患者进行访谈以获取他们的出行信息。采用两步浮动集水区（2SFCA）方法来衡量患者到透析中心的空间可达性。透析中心的容量定义为每个中心活跃透析设施的数量，每个区域的血液透析患者被视为透析服务的使用者。通过克里金插值算法在研究区域内直观显示每位患者住所到血液透析设施的出行成本。研究区域北部到透析中心的空间可达性较差。幸运的是，该区域的血液透析患者不多。与研究区域的其他地方相比，北部地区患者的出行成本较高。我们观察到自我报告的出行时间与计算得出的空间可达性之间存在统计学上显著的负相关（-0.570，P值<0.01，双尾斯皮尔曼检验）。本研究支持这样一种观点，即2SFCA方法可能与透析设施的实际可达时间相关，尤其是在交通流量小且地势平坦的地区，如呼罗珊北部。绘制患者分布以及到血液透析设施的插值出行成本图，有助于政策制定者将卫生资源分配到需求更大的地区。
