158. Understanding the Impact of Accessibility on Hemodialysis Outcomes in India
Invited abstract in session ME-1: Access to care, stream Sessions.
Monday, 15:30-17:00Room: NTNU, Realfagbygget R5
Authors (first author is the speaker)
| 1. | Sachin Bodke
|
| IEOR, IIT Bombay | |
| 2. | Narayan Rangaraj
|
| Industrial Engineering and Operations Research, Indian Institute of Technology Bombay |
Abstract
Hemodialysis is a vital treatment for patients with End-Stage Renal Disease, but many in India face challenges in accessing it regularly due to travel burden and associated costs. This study analyzes dialysis accessibility and its link to treatment adherence and survival outcomes using data from 16,104 patients undergoing dialysis for over 90 days. It combines Geographic Information System data, survival analysis, and logistic regression to assess how distance, center type, and location affect care patterns.
Patients receiving irregular dialysis traveled significantly longer compared to those with regular dialysis (20 vs. 13 km) and had shorter median survival (6.2 vs. 9.6 years). While average travel distances to public and private centers were similar (~33 km), public centers saw more frequent dialysis and served a broader cross-section of patients. Adherence was better in Tier 1 cities, and logistic regression confirmed tier and travel distance as key predictors. Among the states analyzed, Telangana, showed high adherence and survival despite longer average travel.
A patient survey supported these findings, where 67% reported financial stress and 26% missed sessions due to travel issues. Many spent up to 2000 Rs per trip and relied on caregivers for visits. These insights suggest that improving access through transport support and better distribution of services can help patients maintain regular care and improve health outcomes.
Keywords
- Access and waiting list
- Strategic and operational planning
- Health Services Research
Status: accepted
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