Date of Award
4-2026
Document Type
Dissertation
Degree Name
D.S.W. Social work
Department
Social Work
First Advisor
Stephen W. Stoeffler
Second Advisor
Moira Conway
Third Advisor
FangHsun Wei
Abstract
Access to dialysis treatment is a major concern for the over 500,000 people who suffer from End Stage Renal Disease (ESRD). There are many factors that may affect one's ability to access treatment, but one that affects almost every in-center dialysis patient is transportation. This study examines how various spatial disparities, such as population density, Medicare coverage, Medicaid usage, poverty, commute times, and vehicle ownership, affect missed and shortened treatments due to transportation. To examine the relationship between spatial disparities and transportation-impacted treatment adherence, a random sample of 400 clinics were emailed to participate in the study, with 113 agreeing to participate. A correlational analysis was conducted between the 6 spatial disparities and the rates of missed and shortened treatments due to transportation. A significant but weak correlation was noted between shortened treatments and urban percentage (.240**), poverty rate (-.224*), and commute time (.214*). There were no significant correlations between any of the other spatial disparities and missed treatments due to transportation. Results indicated a possible significant relationship between spatial disparities and a clinic’s treatment adherence rate, as evidenced by the three statistically significant correlations. Additionally, GIS analysis was used to visualize the data, producing 14 maps. To visualize the dependent variables related to treatment adherence, choropleth maps with graduated symbology were created, while bivariate 3x3 symbology maps were used to visualize the relationship between independent and dependent variables. This data showed that while spatial disparities may impact treatment adherence other factors may also be at play and the impact that social workers play on treatment adherence is not to be minimized.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Kirschner, Haylee, "The Impact of Spatial Disparities on Transportation to Dialysis: A Quantitative and GIS Analysis" (2026). Social Work Doctoral Dissertations. 48.
https://research.library.kutztown.edu/socialworkdissertations/48
