Ghahramani Peyman, Kiani Behzad, Norouzkhani Narges, Khoshkangin Atefeh, Kheirdoust Azam, Mazaheri Habibi Mohammad Reza
Department of Health Information Technology Varastegan Institute for Medical Sciences Mashhad Iran.
Department of Medical Informatics, School of Medicine Mashhad University of Medical Sciences Mashhad Iran.
Health Sci Rep. 2025 Aug 7;8(8):e71137. doi: 10.1002/hsr2.71137. eCollection 2025 Aug.
Chronic kidney disease (CKD) poses a substantial global health challenge, contributing to increased morbidity and mortality, diminished quality of life, and escalating healthcare expenditures. Despite advancements in nephrology and dialysis technologies, disparities in hemodialysis (HD) accessibility remain prevalent, leading to suboptimal patient outcomes and increased healthcare burdens. Geographic Information Systems (GIS) facilitate the spatial analysis of healthcare service distribution, identifying inequities in access. This study employs GIS to evaluate the spatial distribution of dialysis facilities in Shiraz, highlight underserved areas, and assess geographic barriers impacting patient access.
A GIS-based spatial analysis was performed utilizing deidentified patient demographics, dialysis facility locations, transportation network data, and urban zoning characteristics to assess accessibility and service distribution. Sophisticated geospatial methodologies, including Network Analysis and Kernel Density Estimation (KDE), were employed to model travel time variations and evaluate spatial equity in-service distribution. The study adhered to SAMPL and CONSORT reporting guidelines.
Among 605 patients (mean age: 60.9 ± 15.4 years; 64.6% male), substantial spatial disparities in dialysis service accessibility were identified, with notable variations in travel burden and facility distribution. Patients from socioeconomically disadvantaged neighborhoods experienced prolonged travel times and increased transportation expenses, further intensifying healthcare access disparities. GIS-based spatial modeling identified priority zones for service expansion, proposing targeted interventions to optimize resource allocation.
Socioeconomic inequities substantially impact dialysis accessibility, concentrating patients in cost-effective residential areas with heightened travel burdens and delayed treatment initiation. GIS-driven spatial planning provides a data-driven framework for equitable dialysis resource allocation, facilitating evidence-based healthcare policy decisions.
慢性肾脏病（CKD）对全球健康构成了重大挑战，导致发病率和死亡率上升、生活质量下降以及医疗保健支出不断增加。尽管肾脏病学和透析技术取得了进展，但血液透析（HD）可及性方面的差异仍然普遍存在，导致患者预后不佳和医疗负担加重。地理信息系统（GIS）有助于对医疗服务分布进行空间分析，识别可及性方面的不平等。本研究采用GIS评估设拉子透析设施的空间分布，突出服务不足地区，并评估影响患者可及性的地理障碍。
利用匿名患者人口统计学数据、透析设施位置、交通网络数据和城市分区特征进行基于GIS的空间分析，以评估可及性和服务分布。采用复杂的地理空间方法，包括网络分析和核密度估计（KDE），对出行时间变化进行建模，并评估服务分布的空间公平性。该研究遵循SAMPL和CONSORT报告指南。
在605名患者中（平均年龄：60.9±15.4岁；男性占64.6%），发现透析服务可及性存在显著的空间差异，出行负担和设施分布存在明显变化。来自社会经济弱势社区的患者出行时间延长，交通费用增加，进一步加剧了医疗可及性差距。基于GIS的空间建模确定了服务扩展的优先区域，提出了有针对性的干预措施以优化资源分配。
社会经济不平等对透析可及性有重大影响，使患者集中在出行负担加重且治疗开始延迟的高性价比居住区域。基于GIS的空间规划为公平的透析资源分配提供了一个数据驱动的框架，有助于做出基于证据的医疗保健政策决策。
