Towards developing an integrated index of access to dialysis facilities: A systematic review

Abstract

Background: The equitable Access to Healthcare Services (AHS) constitutes one of the main priorities of the healthcare providers. Access to Dialysis Facilities (ADF) has an important impact on the renal dialysis patients. There are many spatial and non-spatial factors that potentially can affect ADF.

Objectives: We aimed to review available literature on factors affecting ADF. We have also tried to identify knowledge gaps in current studies in order to use those elicited factors to cover these gaps in developing an integrated index of ADF.

Methods: In May 2016, the literature was systematically searched using the following electronic databases: PubMed, Embase, Web of science, Scopus, Science Direct, and IEEE Xplore. A 3-step method to identify studies related to ADF was used. Study selection processes were performed by two independent reviewers. The quality of studies was assessed using a mixed approach scoring system.

Results: Initially, 975 literature were identified searching the selected databases. After removing duplicates, study screening, and applying inclusion/exclusion criteria, 34 studies were identified for final review. Given the content of selected studies, three groups of studies were identified and 42 factors with the potential effect on ADF were determined.

Conclusion: Our systematic research revealed that most of the factors with the potential effect on ADF are non-spatial. Such factors were underseen in many studies focusing mainly on the spatial dimensions of ADF. We recommended that all possible spatial and non-spatial factors together should be taken into account as part of an integrated index of ADF.