Disadvantaged Communities Have Decreased Access to Dialysis Facilities

THURSDAY, Feb. 26, 2026 (HealthDay News) — As community disadvantage increases, access to dialysis facilities decreases, according to a research letter published online Feb. 23 in JAMA Internal Medicine.

Yu-Chu Shen, Ph.D., from the Department of Defense Management in Monterey, California, and Renee Y. Hsia, M.D., from University of California, San Francisco, examined whether geographic access to dialysis facilities varied by community socioeconomic status (measured by Area Deprivation Index [ADI], defined at the ZIP code level using 2020 data) using national CMS Dialysis Facility Care Compare, U.S. census, and social determinants of health (SDOH) data from January to December 2025.

The researchers identified 6,961 dialysis facilities with hemodialysis capacity located within a 30-minute drive from 23,737 of 33,338 communities (21,881 communities with valid ADI values; 307 million of 327 million people). Disadvantaged communities had substantially lower access to dialysis services, with 2.3 percent of the most advantaged communities lacking a dialysis facility within 30 minutes versus 11.7 percent of the most disadvantaged communities (odds ratio, 5.56). The mean number of dialysis stations within 30 minutes decreased from 31.0 per 1,000 residents (most advantaged) to 13.2 per 1,000 residents (most disadvantaged).

“Our findings underscore the importance of regulatory oversight and incorporating community-level SDOH data, like ADI, into payment adjustment and infrastructure planning to prioritize equity and efficiency in health care services,” the authors write. 

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