For millions of Americans, transportation is a major barrier to accessing healthcare. Missed appointments lead to interrupted care, interruption of medication regimens, loss of screening opportunities and a host of other negative consequences. When poorer populations are involved, these issues compound. In 25 separate studies, 10-51 % of patients reported that transportation barriers were the primary reason for missing clinic appointments [1].
A recent study by athenahealth found that when patients who missed one or more healthcare appointments did not return to their physician, they were 70% more likely not to go back within 18 months. In many cases, these are chronically ill patients with conditions such as diabetes, asthma, arthritis and cancer who are at the highest risk for complications if they do not have regular care.
In a new study from Penn Medicine published in JAMA Internal Medicine, researchers sought to reduce the number of Medicaid patients who missed appointments due to transportation barriers by offering free Lyft rides for their next scheduled visit. The results of the pilot trial were mixed, with no significant difference in missed appointment rates between the intervention and control groups.
Missed appointment rates were higher among patients who lived in census tracts with the greatest racial/ethnic segregation, lowest levels of social capital and perceived safety, the most poverty, and the highest incidence of violent crime. After controlling for patient-level and clinic-level characteristics, women had a slightly increased predicted probability of delaying medical care because of a transportation barrier than men. percentage of missed healthcare appointments because of travel