Three Times a Week:Mapping the Transportation of DialysisPatients in the Greater Dayton AreaAmbreen Hasan and Langdon SandersMasters of Public AdministrationWright State UniversityMay 15, 2013
Purpose:• Examine current transportation system fordialysis patients in Montgomery, Miami &Greene co.• To Inform Decision Makers:– Identify Target Areas, Issues & ChallengesTowards Improving Service, Reducing Cost
Limitations:• Data used includes patients who use servicesprovided by RTA, Anton’s, Greene CATS, MCPTand Fairborn Sen. Center.• Straight lines distance used instead of actualdistance.• Different date ranges of data.• Observed only two centers (both inMontgomery County).
Methodology• Transit records, Field observation, Secondarydata analysis, and Patient survey.• The usual (and unusual) obstacles:IRB (HIPAA) & Dialysis Center Approval.Raw Data Entered toMaster Sheet (Excel)Addresses + DataMapped (Geocoding)Mapping Analysis
Direct Observation Findings51%10%16%1%22%Personal VehicleRTA (Project mobility)Ambulette (E.M.T., America, Medcorps)GreeneCATS Taxi/VanHow People Travel to Dialysis(n=77)*Observations done at the two centers located in Dayton*Data includes both arriving and departing vehicles from the centerDayton YellowAir CityAll AmericaEagle OneNubta TransMedmobileAnton’s Trans.
Upper Valley Medical CenterFresenius Medical CareDaVita DialysisDaVita DialysisDaVita Dayton NorthDaVita SouthDaVita Dayton EastFresenius Medical Care
Patient Distance to Dialysis CenterAll PatientsWithin 5miles85.7%Others4.3%MiamiCountyTravelers10.0%Outside14.3%Percent of Patients LivingWithin 5 Miles of a Dialysis Center
Nearest Center Results:• 40% not going to nearest center– Weighted by GDRTA with 111 trips88%86%53%45%12%14%47%55%Greene CATS (n=17)MCPT (n=51)AntonsTransportation (n=30)Greater Dayton RTA(n=111)Percent Travelling to Nearest Center;by Provider(n=210) Yes No
Where do we go from here?Patients• Educate &empower ofoptionsavailable (suchas where othercenters arelocated &rideshareopportunities)TransitProviders• Further study• Show mismatchof serviceduplication andinefficiencies• Avoid tripduplication• Promoterideshare• Talk with otherprovidersMedicalCommunity• Work withpatients to IDwillingness tochange• Explain dialysiscenterassignmentprocess - includetransportation indecision• ID where changescan/cannot bemade
Further Study• Solicit Feedback from Trans Providers and MedicalCommunity– Ask for Additional Direction and Research Questions• Sort by destinations, look forneighbors, opportunities to coordinate/ride share• Leverage incentives for choosing closer centers
Thank you• Mr. Bob Steinbach, Dir. of RegionalInitiatives, MVRPC• Dr. Myron Levine, Faculty, Wright State University• Mr. Martin Kim, GIS Instructor & Dir. of RegionalPlanning, MVRPC• Ms. Nancy Barr, Nephrology Social Worker, DaVitaDayton• Transit Providers:• Ms. Regan Snider, MCPT• Ms. Susan Eason, GDRTA• Mr. Ken Collier, Greene CATS• Mr. Anthony Smith, Anton’s Transportation• Mr. Jim Adams, Fairborn Senior Center