All ETDs from UAB

Advisory Committee Chair

Akhlaque Haque

Advisory Committee Members

Janet Bronstein

Michael Howell-Moroney

Document Type

Thesis

Date of Award

2008

Degree Name by School

Master of Public Administration (MPA) College of Arts and Sciences

Abstract

Objective: This study examined relationships between racial composition of zip codes and the geographic accessibility to dialysis centers of Network 6 of the End Stage Renal Disease Networks. Study Design: Geographic accessibility to renal care (hemodialysis) was defined as the average distance between the centers of zip codes where dialysis patients reside and the dialysis centers that fall within a 30 mile buffer radius. Data Sources: This research studies the distribution of 33,536 patients, 1,798 zip codes, and 546 dialysis centers in Georgia, North Carolina, and South Carolina as of December 31, 2007. Information and data concerning the dialysis centers located in Network 6 is received and certified by Medicare. The data used in this analysis is provided by the Southeastern Kidney Council Inc (Network 6) are zip codes of residence and the number of patients currently dialyzing in Network 6 Units as of December 31, 2007. Principle Findings: There are significantly more dialysis centers located within a 30 mile radius of Black zip codes in comparison to other zip codes (p = 0.0315). The average ii number of dialysis centers within 30 miles of all zip codes is 15 centers. The average distance to these centers from the center of the zip code boundaries is significantly lower (p=0.0001) in Black zip codes (17.46miles) in comparison to other zip codes (18.82 miles). More interestingly, there are more centers within a 30 mile radius per patient residing in the zip code for other race-populated zip codes (2.36 centers/patient) in comparison to Black zip codes (1.24 centers/patient), p=0.0052. The average number of centers per patient is every zip code is 2.08 centers per dialysis patient. Conclusions: Based on statistical evidence, the geographic accessibility to healthcare facilities and racial composition of zip codes can be used to determine healthcare disparities and the deprivation of resources in areas of medical needs. Results also indicate the Geographic Information Systems can be use to determine geographic access to healthcare services and further exploration of disparities of waiting time for dialysis patients.

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