EnROUTE is a mixed methods study designed to integrate patient, provider, and community perspectives with epidemiologic data to address transportation insecurity in patients with end stage kidney disease (ESKD) treated with in-center hemodialysis.
Over five million individuals in the United States miss or delay medical care because of a lack of transportation, leading to missed appointments, delayed treatment, and increased cost to the healthcare system. Individuals of low socioeconomic status, belonging to racial minority groups, and those living with chronic diseases face increased transportation barriers. Despite transportation being a key factor to accessing healthcare, there are no evidence-based solutions to address this recalcitrant problem. Funded by a KL2 award, EnROUTE is a mixed-methods cohort study to investigate how transportation insecurity impacts dialysis outcomes and patients’ quality of life and to develop interventions addressing transportation insecurity. We will accomplish these goals through the following aims: 1) Describe how persons with ESKD treated with in-center HD and their care teams navigate transportation insecurity. 2) Quantify factors associated with transportation needs and clinically relevant dialysis outcomes. 3) Develop and explore acceptability of a model to address transportation insecurity for persons treated with HD. The study brings together health and transportation sectors to develop innovative solutions to a persistent challenge in healthcare access: transportation insecurity.