Monday, November 20, 2023

Dialysis centers have increasingly moved into rural areas, but travel still remains an obstacle, a new study finds

The treatment schedule ESRD requires means most
patients can't work. (Photo by Annie Spratt, Unsplash)
Once Medicare and Medicaid began covering dialysis costs, for-profit centers started opening in areas where larger clusters of patients live. A new study shows dialysis centers have increasingly moved into rural areas, reports Liz Carey of The Daily Yonder. Jan Probst, a researcher at the Rural and Minority Health Research Center in South Carolina, conducted a study that "looked at where dialysis centers are located and who lives in those areas, then compared the findings to similar past studies."

Dialysis cleans the blood, a job kidney organs usually do, but dialysis is used when kidneys fail due to end-stage renal disease. ESRD can be "caused by diabetes and high blood pressure, among other things," Carey writes. "Patients come to dialysis facilities and spend hours hooked up to machines that remove the blood from their body, filter it through an artificial kidney, and return it to the body."

In general, Probst's study showed that "rural residents have to travel farther to get to dialysis treatment facilities," Carey writes. "This isn't unexpected, she said. In the rural Southeast and Southwest, greater distances between communities mean those residents have to travel farther to get to their treatments. Rural residents, on average, have to travel just over 14 miles to get to the nearest facility. In contrast, urban residents live about 4.5 miles from the nearest dialysis center."

While rural residents still travel further for the expensive treatment, Probst notes her new study shows "a vast improvement from the last time Probst did the same research in 2013. In that study, rural residents had to travel about 40 miles to get to a dialysis facility," Carey writes. "The increase in access to dialysis centers isn't solely due to need, Probst said. Since her 2013 study, how dialysis is funded has changed. Now, federal policy requires Medicare and Medicaid to pay for dialysis treatments. And once Medicaid and Medicare guaranteed payment, Probst said, the market responded."

Even though most rural residents with ESRD may live closer to dialysis centers, the treatment is needed three times a week, and centers often don't offer evening or weekend care. Carey reports, "The burden dialysis places on rural patients would make maintaining any kind of job extremely difficult, Probst said." Probst told her: "I suspect that for most of these folks that [working] is not feasible, and they probably also have multiple things to deal with. They've lost their kidneys, but they still have to deal with their dialysis. There's a lot going on."

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