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Agencies seeking solutions  to dialysis transport demands

Dialysis patients’ use of public transportation rises

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By James Cummings, Staff Writer 11:15 PM Sunday, June 14, 2009

Between 9 and 9:30 Wednesday morning, June 19, five cars, a private ambulance and two Project Mobility vans arrived to drop off kidney dialysis patients at the east location of Dialysis Centers of Dayton.

Twice as many vehicles pass through the lot about five hours later as the morning shift of patients leaves and the afternoon shift arrives. And the east location isn’t the busiest in the Dialysis Centers of Dayton system, said Michael O’Connell, the centers’ CEO.

O’Connell said Dialysis Centers of Dayton provided a total of 43,589 dialysis treatments in 1998, and by last year that number had ballooned to 74,510.

And each of those treatments required that a patient be brought to a dialysis center and taken home a few hours later.

“At least 50 (percent) to 55 percent of our clients use transportation resources from the community,” said staff social worker Tara Cumbow of the Dialysis Centers. “We’re really fortunate that we have as many transportation resources as we do. So far, everybody who needs help getting here, we’ve been able to find a way.”

The growth in local demand for dialysis treatment is part of a national trend, O’Connell said. The number of people on dialysis in Ohio grew at a rate of about 8 percent a year in the late 1990s and has continued to grow at a slower 3 percent rate in recent years.

O’Connell said the Dayton area has about 1,100 patients on dialysis, including 525 in five locations of Dialysis Centers of Dayton.

He said a number of factors contribute to the increase in dialysis treatments, including the general aging of the population. Also, medical advances mean people are living longer, giving greater opportunities for kidney disease to develop.

Cumbow said she spends a lot of her time each week trying to help patients make transportation arrangements to get to and from dialysis appointments.

Though more than half the centers’ patients use a transportation service, Cumbow said the simplest solutions are found closer to home.

“We ask if they have family or friends who could drive them,” Cumbow. “Maybe there’s somebody at church.

“After that, we find out if they’re able to ride in a cab. Do they have insurance that would cover a private ambulance? Are they eligible for Project Mobility, and are they in the right service area? Sometimes there are senior citizen centers that have vans.”

Providing dialysis transportation represents a major commitment for friends and family members. Patients must show up on time at a dialysis center three times a week. And they must be picked up four or five hours later.

Theodore Montgomery of Dayton, an 82-year-old dialysis patient, said his sister-in-law offered to transport him to his appointments. But he said she’s in her 70s and is caring for an ailing husband.

“I couldn’t let her do it,” Montgomery said. “It was just too much for her to try to do.”

Allison Ledford, operations manager for the Greater Dayton Regional Transit Authority, is working to reduce the demand on its Project Mobility service.

The agency offers free rides on its fixed routes to riders eligible for Project Mobility who don’t always need the special van service, for instance. Also, there are efforts under way to coordinate better with other social service transportation providers.

O’Connell said the Dialysis Centers are on the brink of getting permission to equip some patients with portable dialysis machines that can be used at home with the help of a family member. The devices will eliminate the need for those patients to come to the centers three times a week.

For the time being, though, Ledford said the ever-increasing number of dialysis patients using Project Mobility are a concern.

“Sometimes patients leaving dialysis are kind of physically weakened,” she said. “Our people aren’t medically trained to give them all the help they may need.”

Contact this reporter at (937) 225-2395 or jcummings@DaytonDailyNews.com.

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