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Travel Distance to Dialysis and Mortality Among Hemodialysis Patients in a Geographically Small Country.

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Title: Travel Distance to Dialysis and Mortality Among Hemodialysis Patients in a Geographically Small Country.
Authors: Namimi-Halevi, Chen1,2 (AUTHOR) namimihalevi@mail.tau.ac.il, Keinan-Boker, Lital2,3 (AUTHOR) lital.keinan2@moh.gov.il, Dichtiar, Rita2 (AUTHOR) rita.dichtiar@moh.gov.il, Beckerman, Pazit4,5 (AUTHOR) pazit.beckerman@sheba.health.gov.il, Bromberg, Michal1,2 (AUTHOR) michal.bromberg@moh.gov.il
Source: Journal of Community Health. Dec2025, Vol. 50 Issue 6, p1115-1126. 12p.
Subject Terms: *Health services accessibility, *Diversity & inclusion policies, *Data analysis, *Chronic diseases, *Adults, Mortality risk factors, Sex distribution, Socioeconomic factors, Kruskal-Wallis Test, Population geography, Hemodialysis facilities, Hemodialysis, Age distribution, Hospitals, Transportation, Chronic kidney failure, Kaplan-Meier estimator, Analysis of variance, Statistics, Sociodemographic factors, Health equity, Proportional hazards models, Transportation of patients, Sensitivity & specificity (Statistics)
Geographic Terms: Israel
Abstract: Evidence on the association between dialysis facility accessibility and mortality in small countries is limited. This study evaluated the association between travel distance and one- and two-year mortality among Israeli end-stage renal disease (ESRD) patients. Data were obtained from the National Renal Replacement Therapy Registry, encompassing all Israeli ESRD patients aged ≥ 45 years who initiated hemodialysis in 2010–2021. Sociodemographic (age, sex, population group), treatment-related (hospital/community treatment, primary renal disease, incident-year cohort), and geographic (residency socioeconomic and peripherality indices) data were collected. Travel distances from the most recent address to the initial treating facility were categorized into three groups based on the 50th and 90th percentiles, excluding outliers (> 100 km). Adjusted Cox regressions assessed associations between travel distances and mortality, with incident-year cohort-specific models evaluating temporal hazard variations. Analyses included 15,606 patients. The long-distance group (> 26.39 km) was characterized by younger age, Arab ethnicity, peripheral residence, and lower socioeconomic status. Compared to the short-distance group (≤ 6.80 km), the hazard ratios (HRs) in the intermediate-distance group (> 6.80 and ≤ 26.39 km) were 1.216 (1.106–1.337) for one-year and 1.181 (1.093–1.275) for two-year mortality. In the long-distance group, the HRs were 1.718 (1.460–2.021) for one-year and 1.554 (1.351–1.787) for two-year mortality (P-for-trend between travel distances <.001). Sensitivity and temporal analyses confirmed consistent associations across incident-year cohorts, alternative cut-offs, and outlier inclusion. The association between travel distance and mortality highlights the need to improve geographic accessibility to healthcare to reduce inequities, especially for life-sustaining chronic treatments such as hemodialysis. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Community Health is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Travel Distance to Dialysis and Mortality Among Hemodialysis Patients in a Geographically Small Country.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Namimi-Halevi%2C+Chen%22&quot;&gt;Namimi-Halevi, Chen&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; namimihalevi@mail.tau.ac.il&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Keinan-Boker%2C+Lital%22&quot;&gt;Keinan-Boker, Lital&lt;/searchLink&gt;&lt;relatesTo&gt;2,3&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; lital.keinan2@moh.gov.il&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Dichtiar%2C+Rita%22&quot;&gt;Dichtiar, Rita&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; rita.dichtiar@moh.gov.il&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Beckerman%2C+Pazit%22&quot;&gt;Beckerman, Pazit&lt;/searchLink&gt;&lt;relatesTo&gt;4,5&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; pazit.beckerman@sheba.health.gov.il&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Bromberg%2C+Michal%22&quot;&gt;Bromberg, Michal&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; michal.bromberg@moh.gov.il&lt;/i&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Journal+of+Community+Health%22&quot;&gt;Journal of Community Health&lt;/searchLink&gt;. Dec2025, Vol. 50 Issue 6, p1115-1126. 12p.
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  Data: Evidence on the association between dialysis facility accessibility and mortality in small countries is limited. This study evaluated the association between travel distance and one- and two-year mortality among Israeli end-stage renal disease (ESRD) patients. Data were obtained from the National Renal Replacement Therapy Registry, encompassing all Israeli ESRD patients aged ≥ 45 years who initiated hemodialysis in 2010–2021. Sociodemographic (age, sex, population group), treatment-related (hospital/community treatment, primary renal disease, incident-year cohort), and geographic (residency socioeconomic and peripherality indices) data were collected. Travel distances from the most recent address to the initial treating facility were categorized into three groups based on the 50th and 90th percentiles, excluding outliers (&gt; 100 km). Adjusted Cox regressions assessed associations between travel distances and mortality, with incident-year cohort-specific models evaluating temporal hazard variations. Analyses included 15,606 patients. The long-distance group (&gt; 26.39 km) was characterized by younger age, Arab ethnicity, peripheral residence, and lower socioeconomic status. Compared to the short-distance group (≤ 6.80 km), the hazard ratios (HRs) in the intermediate-distance group (&gt; 6.80 and ≤ 26.39 km) were 1.216 (1.106–1.337) for one-year and 1.181 (1.093–1.275) for two-year mortality. In the long-distance group, the HRs were 1.718 (1.460–2.021) for one-year and 1.554 (1.351–1.787) for two-year mortality (P-for-trend between travel distances &lt;.001). Sensitivity and temporal analyses confirmed consistent associations across incident-year cohorts, alternative cut-offs, and outlier inclusion. The association between travel distance and mortality highlights the need to improve geographic accessibility to healthcare to reduce inequities, especially for life-sustaining chronic treatments such as hemodialysis. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Journal of Community Health is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1007/s10900-025-01496-0
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 12
        StartPage: 1115
    Subjects:
      – SubjectFull: Health services accessibility
        Type: general
      – SubjectFull: Diversity & inclusion policies
        Type: general
      – SubjectFull: Data analysis
        Type: general
      – SubjectFull: Chronic diseases
        Type: general
      – SubjectFull: Adults
        Type: general
      – SubjectFull: Mortality risk factors
        Type: general
      – SubjectFull: Sex distribution
        Type: general
      – SubjectFull: Socioeconomic factors
        Type: general
      – SubjectFull: Kruskal-Wallis Test
        Type: general
      – SubjectFull: Population geography
        Type: general
      – SubjectFull: Hemodialysis facilities
        Type: general
      – SubjectFull: Hemodialysis
        Type: general
      – SubjectFull: Age distribution
        Type: general
      – SubjectFull: Hospitals
        Type: general
      – SubjectFull: Transportation
        Type: general
      – SubjectFull: Chronic kidney failure
        Type: general
      – SubjectFull: Kaplan-Meier estimator
        Type: general
      – SubjectFull: Analysis of variance
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      – SubjectFull: Statistics
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      – SubjectFull: Sociodemographic factors
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      – SubjectFull: Health equity
        Type: general
      – SubjectFull: Proportional hazards models
        Type: general
      – SubjectFull: Transportation of patients
        Type: general
      – SubjectFull: Sensitivity & specificity (Statistics)
        Type: general
      – SubjectFull: Israel
        Type: general
    Titles:
      – TitleFull: Travel Distance to Dialysis and Mortality Among Hemodialysis Patients in a Geographically Small Country.
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            – D: 01
              M: 12
              Text: Dec2025
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              Y: 2025
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