Transportation can influence the health and well-being of communities. Every year, 3.6 million people in the United States do not obtain medical care due to transportation issues. These issues, which affect rural and urban communities, may result in missed or delayed health care appointments, increased health expenditures and overall poorer health outcomes. Although hospitals and health systems do not traditionally focus on transportation within their purview of care delivery, there is a growing recognition that improving transportation access and support for patients can result in improved outcomes and lower costs for populations. Reliable and safe transportation services are essential for healthy communities.
Strategies for hospitals and health systems
Transportation is necessary to access emergency services, health care, adequate food and clothing, education, employment and social activities. Barriers to transportation greatly affect the quality of people’s lives.
“Transportation and the Role of Hospitals,” recently released by the American Hospital Association’s Health Research & Educational Trust and the Association for Community Health Improvement, discusses how transportation issues affect health and health care access and outlines strategies for hospitals and health systems. Strategies include screening and evaluating patients’ transportation needs, providing transportation services through community partnerships or programs and supporting policy and infrastructure programs that create safer and more accessible transportation options. Transportation also can be a vehicle for wellness through implementation of varied, targeted strategies.
Denver Health Medical Center Partnership with Lyft
At Denver Health Medical Center, hospital leaders noticed the no-show rate for outpatient visits was significant. In addition, patients who had been admitted to the hospital were waiting an extended amount of time after discharge to travel home. After surveying patients, the hospital identified lack of transportation as a primary reason for these problems.
To help patients get to and from the hospital, Denver Health offers free bus tickets, cab vouchers and a private car service through a vehicle donated by Oprah Winfrey that is staffed by retired community residents.
In November 2016, the hospital started a collaboration with the ride-hailing company Lyft to provide vulnerable patients with transportation to and from the hospital. The service was initially limited to patients in the emergency department. After three months, it was expanded to hospital inpatients. The initiative now includes four outpatient clinics as well and is expanding based on the community’s needs and suggestions for improving practices.
During the first three months of this collaboration, Denver Health ordered more than 200 rides from Lyft for patients visiting the hospital and its clinics. Since the partnership began there have been no complaints recorded from patients about lack of transportation.
Multiple strategies and mobile health at CalvertHealth Medical Center
Calvert County, Md., is a rural county with only one highway. People who do not live near the highway or town centers have difficulty accessing essential services. In 2014, CalvertHealth’s community health needs assessment identified access to health care services as one of the community’s top three priority health needs. Lack of transportation was identified as one of the most significant socioeconomic barriers to health in the county. To address transportation barriers and improve health care access and delivery in Calvert County, CalvertHealth Medical Center introduced several initiatives:
- Its Mobile Health Center is a 40-foot, state-of-the-art truck that delivers primary and preventive care to patients who are unable to go to appointments. The Mobile Health Center has two fully equipped exam rooms, a waiting area, classroom space and a wheelchair lift. The hospital created a video tour of the Mobile Health Center.
- Since 2013, CalvertHealth has been a member of a community coalition of health care providers and about 30 local agencies. This coalition has created several programs to address transportation needs for community members including the Transportation Assistance Program. TAP partners with a local taxi service to provide patients with a taxi voucher. The taxi service transports patients in the Calvert County area to and from their medical appointments.
- CalvertHealth CARES Clinic provides a visiting pharmacist for patients experiencing difficulties picking up prescriptions, attending doctor’s appointments or understanding their medication and care plan. The pharmacist delivers medications to patients and educates them about their medication to build health literacy.
In the first six weeks after its launch, the Mobile Health Center provided services to 330 residents at local schools, health fairs, churches and community events. As a result of the community coalition-led initiatives, the hospital has seen a nearly 9 percent reduction in readmission rates.
For more information about these and other initiatives, visit www.aha.org/transportation. “Transportation and the Role of Hospitals” is part of a series of resources from the AHA, HRET and ACHI on how hospitals and health systems can address the social determinants of health, including food insecurity, housing instability and transportation, to improve the environment where people live, work and play. To view all of the resources in this series, visit www.hret.org/sdoh.
Jennie Situ is a program manager with the Health Research & Educational Trust.