The impact of rural status on pediatric chronic kidney disease.
Morgan Bobb SwansonDarcy K WeidemannLyndsay A HarshmanPublished in: Pediatric nephrology (Berlin, Germany) (2023)
Children and adolescents in rural areas with chronic kidney disease (CKD) face unique challenges related to accessing pediatric nephrology care. Challenges to obtaining care begin with living increased distances from pediatric health care centers. Recent trends of increasing centralization of pediatric care mean fewer locations have pediatric nephrology, inpatient, and intensive care services. In addition, access to care for rural populations expands beyond distance and encompasses domains of approachability, acceptability, availability and accommodation, affordability, and appropriateness. Furthermore, the current literature identifies additional barriers to care for rural patients that include limited resources, including finances, education, and community/neighborhood social resources. Rural pediatric kidney failure patients have barriers to kidney replacement therapy options that may be even more limited for rural pediatric kidney failure patients when compared to rural adults with kidney failure. This educational review identifies possible strategies to improve health systems for rural CKD patients and their families: (1) increasing rural patient and hospital/clinic representation and focus in research, (2) understanding and mediating gaps in the geographic distribution of the pediatric nephrology workforce, (3) introducing regionalization models for delivering pediatric nephrology care to geographic areas, and (4) employing telehealth to expand the geographic reach of services and reduce family time and travel burden.
Keyphrases
- healthcare
- end stage renal disease
- chronic kidney disease
- south africa
- palliative care
- newly diagnosed
- ejection fraction
- quality improvement
- primary care
- prognostic factors
- mental health
- systematic review
- young adults
- public health
- physical activity
- gene expression
- pain management
- risk factors
- social media
- smoking cessation
- replacement therapy
- electronic health record
- patient reported