title: A comparison of quality of life and travel-related factors between in-center and satellite-based hemodialysis patients.
abstract: OBJECTIVE
  Shorter travel times and distance to dialysis clinics have been associated with improved patient outcomes and a higher health-related quality of life (HRQOL). The objective of this study was to compare HRQOL between prevalent in-center and satellite dialysis patients, as well as compare travel-related factors that contribute to HRQOL between in-center and satellite-based patients. DESIGN, SETTING, PARTICIPANTS, & MEASURES: The London Health Sciences Centre is a tertiary care center with in-center and regional satellite hemodialysis units. Patients who consented and completed a questionnaire (n = 202) were enrolled into a cross-sectional, cohort observational study. Patients were administered the Medical Outcomes Short-Form 36 (SF-36) and the Kidney Disease Health Related Quality of Life (KDHRQOL) tool and were asked questions relating to travel to dialysis clinics.
  
  
  RESULTS
  Patients who underwent dialysis in the satellites had similar demographics, comorbidities, and laboratory parameters. Patients who underwent dialysis in satellite units reported a significantly superior score on the dialysis stress domain of the KDHRQOL questionnaire. There was no significant difference between in-center and satellite patients on the basis of the SF-36. Satellite patients also reported a significantly decreased cost of transportation, a significantly increased proportion who drive themselves to clinics, and significantly decreased travel time.
  
  
  CONCLUSIONS
  Patients who underwent dialysis in satellite units demonstrated similar characteristics, comorbidities, surrogate outcomes, and most aspects of HRQOL. Travel time, cost, and receiving treatment in one's own community are important factors that may contribute to a trend toward higher reported HRQOL by patients in satellite dialysis units.
authors.affiliation: Division of Nephrology, London Health Sciences Centre, Ontario, Canada.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Diamant
authors.forename: Lori
authors.initials: L
authors.lastname: Harwood
authors.forename: Sujana
authors.initials: S
authors.lastname: Movva
authors.forename: Barbara
authors.initials: B
authors.lastname: Wilson
authors.forename: Larry
authors.initials: L
authors.lastname: Stitt
authors.forename: Robert M
authors.initials: RM
authors.lastname: Lindsay
authors.forename: Louise M
authors.initials: LM
authors.lastname: Moist
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D003151:Community Health Centers / Q000191:economics; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D007676:Kidney Failure, Chronic / Q000191:economics / Q000523:psychology / Q000628:therapy*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010044:Outpatient Clinics, Hospital / Q000191:economics; D011788:Quality of Life; D006435:Renal Dialysis / Q000191:economics / Q000523:psychology; D012111:Residence Characteristics; D011795:Surveys and Questionnaires; D013997:Time Factors; D014187:Transportation of Patients / Q000191:economics; D016896:Treatment Outcome