优化透析中心的全国布局：一种基于地理信息系统的方法，以提高医疗服务的可及性和可得性。

Optimizing nation-wide locations of dialysis centers: a geographic information system-based approach to improve healthcare accessibility and availability.

作者信息

Schroeder Hanna, Namimi-Halevi Chen, Luxenburg Osnat, Grinbaum Arizon Ayelet, Tagar Zach, Bromberg Michal, Eisenberg Vered H

机构信息

Policy Planning Department at the Israel Ministry of Health and an instructor in the Henrietta Szold School of Nursing, Hebrew University - Hadassah Faculty of Medicine, Jerusalem, Israel.

Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel.

出版信息

Isr J Health Policy Res. 2025 Jul 15;14(1):40. doi: 10.1186/s13584-025-00704-5.

DOI:10.1186/s13584-025-00704-5

PMID:40660384

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12261728/

Abstract

BACKGROUND

Accessibility and availability are critical components of quality healthcare, particularly for dialysis patients requiring tri-weekly treatments. Inconveniently placed or oversubscribed dialysis centers contribute to widening healthcare disparities. This study aims to enhance equity in dialysis care by utilizing Geographic Information Systems (GIS) to optimize facility placement through data-driven decision-making.

METHODS

This cross-sectional study analyzed national data from 5,961 hemodialysis patients across 76 dialysis centers in Israel. Geographic accessibility was assessed using GIS to measure travel distances between patients' residences and their treating dialysis centers. For utilization rate, active hemodialysis patient count was compared to estimated maximum capacity for each center. Statistical comparisons across districts were conducted using chi-square, ANOVA, or Kruskal-Wallis tests, with Bonferroni corrections. Findings were visualized using ArcGIS software.

RESULTS

The median travel distance to dialysis centers varied significantly by district (p < 0.001), with the longest distance in the North district (10.9 km) and the shortest in the South district (3.4 km). The mean utilization rate was 73.3%, with the highest in the North district (82.5%) and the lowest in the Jerusalem district (64.3%). No significant differences in utilization rates were found between districts (p = 0.38.

CONCLUSIONS

To our knowledge, this is the first study to apply GIS to national patient-based data for assessing dialysis center accessibility and utilization. Our findings demonstrate how GIS integration with national registries can inform equitable healthcare planning and facility allocation. This approach offers policymakers a scalable, technology-driven strategy to optimize resource distribution, correct healthcare inequities, and improve accessibility for dialysis patients.

摘要

背景

可及性和可用性是优质医疗保健的关键要素，对于需要每三周进行一次治疗的透析患者而言尤为重要。位置不便或过度预约的透析中心会加剧医疗保健差距。本研究旨在通过利用地理信息系统（GIS），通过数据驱动的决策来优化设施布局，从而提高透析护理的公平性。

方法

这项横断面研究分析了来自以色列76个透析中心的5961名血液透析患者的全国数据。使用GIS评估地理可及性，以测量患者住所与治疗透析中心之间的出行距离。对于利用率，将活跃血液透析患者数量与每个中心的估计最大容量进行比较。使用卡方检验、方差分析或克鲁斯卡尔-沃利斯检验对各地区进行统计比较，并进行邦费罗尼校正。研究结果使用ArcGIS软件进行可视化展示。