In-center hemodialysis transportation: an Italian citizens’ committee point of view

Introduction: Transportation insecurity is a problem for people fighting against chronic diseases, and the organization of transportation for in-center hemodialysis (HD) is a complex challenge and long travel times to dialysis centers have been associated with increased mortality risk and poorer health-related quality of life.Methods: We carried out a cross-sectional survey with the aim of identifying and understanding the transportationoptions available to in-center HD patients and to describe their experiences from their perspective.Results: We investigated 132 out of 166 patients treated with HD in the province of Ferrara (mean age 68.6 ±13.9 years, 65% males). An investigation was performed by using a questionnaire. The average distance fromresidence to the dialysis center was 20 ± 14.7 km. 48.5% of users used their own vehicle, while 41.7% used anambulance. A minority of the population used social services vehicles. The average travel time was 29 ± 15 minutes,and when the vehicle was not personal, it was shared with 2.6 passengers in 85% of cases. Transportationfee was reimbursed in 48.5% of cases. Users were dissatisfied or very dissatisfied in 7.5-15.1% of cases. Durationof the journey was the main determinant of patients’ satisfaction, independently of age, gender, and receivingfinancial support for transportation.Conclusion: Although the majority of investigated subjects were satisfied with their transportation arrangements,the burden of traveling to HD is an issue, and its organization should consider economic resources and patients’needs. A validated instrument is needed to understand this complex phenomenon, which is not a logistic item.