Taking Dialysis Near the Doorstep: A GIS Based Approach for Catchment Area Analysis and Insight into Hemodialysis Patient's Perceptions of Extra Mural Dialysis Services in India

Background: Geographic Information System (GIS) is a modern technological tool for plotting and analysing data and making intelligent decisions out of it. Chronic Kidney Disease is one of the leading cause of deaths among noncommunicable diseases. It is observed that CKD patients face problems as they have to frequently travel to dialysis centre, which involves time and money. Due to poor accessibility to dialysis centres, around half such patients are lost to followup. It was therefore decided to find ways to solve the problems of shortage of dialysis centers and accessibility using GIS. Methodology: Observational study, with retrospective analysis of demographic data of all existing dialysis patients on outpatient basis at this hospital for past three years. Based on the pin codes of the localities, we mapped the places of origin of patients. A self-administered questionnaire was study tool that we distributed and collected one time to understand their perceptions on travel costs, convenience. Results: It was found that 77% of patients were from low income families. The age group is 22 to 58 years of age. 62 patients who required dialysis were not given appointment due to lack of available time slots. Patients were willing to pay more for dialysis done at doorstep. This reduces the financial burden to the family members on transportation, food, accommodation costs at our hospital. Conclusion: Setting up extra-mural (beyond hospital walls) dialysis services could act as a novel approach to reaching out to the masses for improving access to specialized healthcare and reducing healthcare burden on the overburdened primary institution at the same time. In addition, it could improve patient retention and compliance rates, having a positive impact on the market share and hospital revenue.