“It’s part of dialysis”: Lived experiences of transportation challenges among patients and staff in in-center hemodialysis

Transportation insecurity significantly affects dialysis care, yet little research examines its impact from both patient and provider perspectives. This qualitative study explored how transportation challenges influence the experiences of patients receiving in-center hemodialysis and dialysis clinic staff. We conducted 78 semi-structured interviews with patients (n=49) and staff (n=29) across four Northern California dialysis clinics. Participants described challenges of navigating two systems, healthcare and transportation, and how this creates emotional distress for patients and staff, disrupts clinic workflows, and compromises treatment adherence. Transportation services are a major part of patient and staff experience in dialysis clinics. Our findings highlight the need to improve transportation for dialysis patients through collaboration between healthcare systems, transportation providers, and community stakeholders.