Accessing hemodialysis clinics during the COVID-19 pandemic. (March 2022)

• Record Type: Journal Article
• Authors: Beaudet, Matthew; Ravensbergen, Léa; DeWeese, James; Beaubien-Souligny, William; Nadeau-Fredette, Annie-Claire; Rios, Norka; Caron, Marie-Line; Suri, Rita S.; El-Geneidy, Ahmed
• Is Part Of: Transportation research interdisciplinary perspectives. Volume 13(2022)
• Publication Date: 2022-03
• Subjects: Hemodialysis -- Access to care -- COVID-19 -- Transportation -- Paratransit; Transportation -- Periodicals; 388.05
• DOI: 10.1016/j.trip.2021.100533
• Languages: English
• ISSNs: 2590-1982

Abstract

Highlights: Dialysis patients were surveyed about their access to treatment during the pandemic. Concerns about contracting COVID were higher while travelling than at the clinic. Fear of COVID was greater amongst those taking paratransit, public transport, or taxis. Some patients who used paratransit found COVID-19 protocols confusing. General dissatisfaction with paratransit travel emerged, including long travel times. Abstract: Transportation is a key element of access to healthcare. The COVID-19 pandemic posed unique and unforeseen challenges to patients receiving hemodialysis who rely on three times weekly transportation to receive their life-saving treatments, but there is little data on the problems they faced. This study explores the attitudes, fears, and concerns of hemodialysis patients during the pandemic with a focus on their travel to/from dialysis treatments. A mixed methods travel survey was distributed to hemodialysis patients from three urban centers in Montréal, Canada, during the pandemic (n = 43). The survey included closed questions that were analysed through descriptive statistics as well as open-ended questions that were assessed through thematic analysis. Descriptive statistics show that hemodialysis patients are more fearful of contracting COVID-19 in transit than they are at the treatment center. Patients taking paratransit, public transportation, and taxis are more fearful of COVID-19 while traveling than those who drive, who are driven, or who walk to the clinic. In the open-ended questions, patients reported struggling with confusing COVID-19 protocols in public transport, including conflicting information on whether paratransit taxis allowed one or multiple passengers. Paratransit was the most used travel mode to access treatment (n = 30), with problems identified in the open-ended questions, such as long and unreliable pickup windows, and extended travel times. To limit COVID-19 exposure and stress for paratransit users, agencies should consider sitting one patient per paratransit taxi, clearly communicating COVID-19 protocols online and in the vehicles, and tracking vehicles for more efficient pickups.