The Burden of Travel-Time and Distance Traveled for Hemodialysis Patients in Australian Major City Areas

The number of Australians receiving long-term dialysis for kidney failure is steadily increasing. Of the 13,051 patients undergoing dialysis at the end of 2017 in Australia, over 70% were receiving “facility” hemodialysis, at a hospital or satellite dialysis unit. In Australia, the type of dialysis facility is dependent on many complex factors, including patient clinical status and medical indications as well as dialysis capacity constraints and dialysis service structures. Typically, patients receive thrice weekly dialysis for 4 to 5 hours per treatment. In addition to time actually receiving hemodialysis, traveling to and from the treatment location is another physical, social, and financial burden for patients and their families, incurred at a high frequency typically for several years. Travel time and associated costs are a barrier to treatment adherence and access. Among those receiving hemodialysis, greater travel times have been associated with shortened and missed dialysis treatments, poorer quality of life, and increased mortality risk. Despite this, there are no published data on actual travel time or distance for patients receiving hemodialysis services in Australia and little elsewhere. For adults receiving facility-based hemodialysis treatment in a Major City in Australia, we estimated travel distance and time from the population centroid of their residential postcode (postal area) to the treatment center.