Accessing hemodialysis clinics during the COVID-19 pandemic

https://doi.org/10.1016/j.trip.2021.100533Get rights and content
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open access

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.

Keywords

Hemodialysis
Access to care
COVID-19
Transportation
Paratransit

Cited by (0)

1

Orcid: 0000-0002-1984-8381.

2

Orcid: 0000-0003-3259-6673.

3

Orcid: 0000-0003-2765-8497.

4

Orcid: 0000-0002-0519-3927.

5

Orcid: 0000-0002-0942-4016.