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Medical literature has identified transportation as a factor in missed and shortened dialysis treatments, which leads to negative health outcomes. These adverse outcomes include, among others, increased hospitalizations because patients do not receive their scheduled treatments. For public transportation agencies, dialysis transportation has become a critical concern as increasing numbers of individuals with end stage renal disease turn to their community’s public transit service for their six trips each week for dialysis.

TCRP Research Report 203: Dialysis Transportation: The Intersection of Transportation and Healthcare responds to major concerns of public transportation agencies about the rising demand and costs to provide kidney dialysis trips and about experiences showing these trips require service more specialized than public transportation is designed to provide.

The report documents the complicated relationship of two different industries—public transportation and healthcare, each with its own perspective and requirements—to highlight problems, identify strategies addressing concerns, and suggest options that may be more appropriate for dialysis transportation.

The following additional materials accompany the report:

• A Supplemental Report that includes, among other material, the literature review and results of the project’s surveys, as well as an assessment of the comprehensive data provided through the U.S. Renal Data System, which underlies the project’s forecasting tool.

• A forecasting tool, which is the community data tool referred to in the report. The Excel forecasting tool enables communities to estimate (1) current and projected demand for public sector trips to kidney dialysis facilities, (2) current and projected costs for this transportation, and (3) potential decreases in the demand for, and cost of, public sector trips if home dialysis increases.

• Info Brief 1 of 2 and Info Brief 2 of 2 capture the key findings of the research project.


Suggested Citation

National Academies of Sciences, Engineering, and Medicine. 2019. Dialysis Transportation: The Intersection of Transportation and Healthcare. Washington, DC: The National Academies Press.

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Publication Info

148 pages |  8.5 x 11 |  DOI:

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