Transportation barriers have been associated with poorer health care access, differential treatment, missed or delayed medical appointments, and lower health status (Fitzpatrick, Powe, Cooper, Ives, & Robbins, 2004; Goodwin, Hunt, & Samet, 1993; Gwira et al., 2006; Horton & Johnson, 2010; Okoro, Strine, Young, Balluz, & Mokdad, 2005; Rittner & Kirk, 1995). Transportation has been recognized as a key ele- ment of health care access, which highlights its role to offset long-term health consequences. Delayed medical care may adversely affect patients’ quality of life and result in more depressive symptoms (Owsley et al., 2007). These delays can also lead to an increased need for emergency care and pre- ventable hospitalizations and result in higher medical costs (Hughes-Cromwich & Wallace, 2006; Rust et al., 2008).
Approximately 3.6 million adults miss or delay non- emergency medical care due to transportation barriers (Hughes-Cromwich & Wallace, 2006). The population missing these visits may be particularly susceptible to poorer health status and higher cost of care. These transpor- tation barriers are more likely to influence older individu- als, females, minorities, and those with lower income levels (Hughes-Cromwich & Wallace, 2006; U.S. Government Accountability Office, 2003). Medicaid acknowledges the importance of transportation for vulnerable populations and the associated potential costs of delayed medical care (Kim, Norton, & Stearns, 2009). In fact, federal Medicaid requires that states “ensure necessary transportation for recipients to and from providers” to help meet the needs of this population and the intent of Medicaid (The Hilltop Institute, 2008).
Bellamy,G. R., Stone,K., Richardson,S. K., & Goldsteen,R. L. (2003). Getting from here to there: Evaluating West Virginia’s rural nonemergency medical transportation program. Journal of Rural Health, 19(Suppl), 397–406.
Community Transportation Association of America. (2008). Federal
Register, 73, 245. http://web1.ctaa.org/webmodules/webarticles/
articlefiles/cms1219.pdf.
Community Transportation Association of America. (2009). America’s Affordable Health Choices Act of 2009. http:// www.ctaa.org/webmodules/webarticles/articlefiles/AAHCA_ BillText_071409.pdf.
Community Transportation Association of America. (2010). An overview: How health care reform impacts community and public transportation. http://web1.ctaa.org/webmodules/webar- ticles/anmviewer.asp?a=1672&z=5.
Fitzpatrick,A. L., Powe,N. R., Cooper,L. S., Ives,D. G., & Robbins,J.
A. (2004). Barriers to health care access among the elderly and
who perceives them. American Journal of Public Health, 94,
1788–1794. http://dx.doi.org/10.2105/AJPH.94.10.1788.
Goodwin,J. S., Hunt,W. C., & Samet,J. M. (1993). Determinants of cancer therapy in elderly patients. Cancer, 72, 594–601.
Gwira,J. A., Vistamehr,S., Shelsta,H., Bashford,K., Forster,S., Palmisano,P., Shafranov,G., & Shields,M. B. (2006). Factors associated with failure to follow up after glaucoma screening: a study in an African American population. Ophthalmology, 113, 1315–1319. http://dx.doi.org/10.1016/j.ophtha.2006.04.017
Horton,S., & Johnson,R. J. (2010). Improving access to health care for uninsured elderly patients. Public Health Nursing, 27, 362– 370. doi:10.1111/j.1525-1446.2010.00866.x
Hughes-Cromwich,P. & Wallace,R. (2006). Cost benefit analy-
sis of providing non-emergency medical transportation.
Transportation Research Record: Journal of the Transportation
Research Board, 1956, 86–93. doi:10.3141/1956-11
Kim,J., Norton,E. C., & Stearns,S. C. (2009). Transportation brokerage services and Medicaid beneficiaries’ access to care. Health Services Research, 44, 145–161. doi:10.1111/j.1475-6773.2008.00907.x
Leduc,N., Tannenbaum,T. N., Bergman,H., Champagne,F., Clarfield,A. M., & Kogan,S. (1998). Compliance of frail elderly with health services prescribed at discharge from an acute-care geriatric ward. Medical Care, 36, 904–914. doi:10.1097/00005650-199806000-00013
Leutz,W., & Capitman,J. (2007). Met needs and unmet needs, and satisfaction among Social HMO members. Journal of Aging & Social Policy, 19, 1–19. doi:10.1300/J031v19n01_01
Lynott,J., Fox-Grage,W., & Guzman,S. (2013). Weaving it together: A tapestry of transportation funding for older adults. AARP Public Policy Institute. http://www.aarp.org/research/ppi/liv- com2/policy/transportation/articles/weaving-it-together-trans- portation-funding-for-older-adults-AARP-ppi-liv-com.html
Nasvadi,G. E. & Wister,A. V. (2006). Informal social support and use of a specialized transportation system by chronically ill older adults. Environment and Behavior, 38, 209–225. doi:10.1177/0013916505277605
Owsley,C., McGwin,G. Jr, Scilley,K., Meek,G. C., Seker,D., & Dyer,A.
(2007). Effect of refractive error correction on health-related
quality of life and depression in older nursing home residents.
Archives of Ophthalmology, 125, 1471–1477. doi:10.1001/
archopht.125.11.1471
Rittner,B., & Kirk,A. B. (1995). Health care and public transpor-
tation use by poor and frail elderly people. Social Work, 40,
365–373. http://search.proquest.com/docview/1297015299?acc
ountid=14496
Rust,G., Ye,J., Baltrus,P., Daniels,E., Adesunloye,B., & Fryer,G. E. (2008). Practical barriers to timely primary care access: Impact on adult use of emergency department services. Archives of Internal Medicine, 168, 1705–1710. doi:10.1001/ archinte.168.15.1705
The Hilltop Institute. (2008). Non-Emergency Medical Transportation (NEMT) Study Report. http://www.hilltopinsti- tute.org/publications/Non-EmergencyMedicalTransportationSt udyReport-September2008.pdf.
Whittier,S., Scharlach,A. E., & Dal Santo,T. S. (2005). Availability
of caregiver support services: Implications for implementation
of the National Family Caregiver Support Program. Journal of
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Yeatts,D. E., Crow,T., & Folts,E. (1992). Service use among low- income minority elderly: Strategies for overcoming barriers. The Gerontologist, 32, 24–32. doi:10.1093/geront/32.1.24
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Today's Topics:
1. Access to Health Care (Ed Christopher)
2. Re: Access to Health Care (Rajiv Bhatia)
3. Re: Access to Health Care (denita Jones)
4. Re: Access to Health Care (Rajiv Bhatia)
----------------------------------------------------------------------
Message: 1
Date: Fri, 28 Feb 2014 14:43:16 -0600
From: Ed Christopher <edc@berwyned.com>
Subject: [H+T--Friends] Access to Health Care
To: TRB Health and Transportation <h+t--friends@chrispy.net>
Message-ID: <5310F4E4.9060008@berwyned.com>
Content-Type: text/plain; charset=ISO-8859-1; format=flowed
I got asked a question today, from a transportation perspective,
about access to health care and health facilities. As I started to hunt
around on the web I thought I would throw it out to our Listserve. Does
anyone know of any research, literature or other articles that they
could pass along dealing with access to health care services?
Thanks
--
Ed Christopher
------------------------------
Message: 2
Date: Fri, 28 Feb 2014 13:13:39 -0800
From: Rajiv Bhatia <rb6419@gmail.com>
Subject: Re: [H+T--Friends] Access to Health Care
To: TRB Health and Transportation <h+t--friends@chrispy.net>
Message-ID: <73BF7334-5E7C-4BC7-8B00-1C6139B8B486@gmail.com>
Content-Type: text/plain; charset=us-ascii
There is limited information on this topic. I did a review of this and other EJ impacts for EPA a few years ago.
A few studies have looked at transport access to facilities and their association to health outcomes. Most studies treated the "exposure variable" as auto ownership. Net conclusion is that auto owners have better access to health facilities. THere is a very limited association to health outcomes.
I would not take this as a null result -- just one that has been understudied.
Rajiv
On Feb 28, 2014, at 12:43 PM, Ed Christopher <edc@berwyned.com> wrote:
> I got asked a question today, from a transportation perspective,
> about access to health care and health facilities. As I started to hunt
> around on the web I thought I would throw it out to our Listserve. Does
> anyone know of any research, literature or other articles that they
> could pass along dealing with access to health care services?
>
> Thanks
> --
> Ed Christopher
> _______________________________________________
> H+T--Friends mailing list
> H+T--Friends@chrispy.net
> https://www.chrispy.net/mailman/listinfo/h+t--friends
------------------------------
Message: 3
Date: Fri, 28 Feb 2014 15:12:18 -0600
From: denita Jones <denita944@gmail.com>
Subject: Re: [H+T--Friends] Access to Health Care
To: TRB Health and Transportation <h+t--friends@chrispy.net>
Message-ID:
<CAKZGZAxDq9_5x+JQrc_Z3oL5oFe5yYaE4zKh=5vJ7_jHgdNnmA@mail.gmail.com>
Content-Type: text/plain; charset="iso-8859-1"
Im actually presenting research in that area in DC next month. I'm not in a
position now to give the names of articles (im driving) But I can send them
to you and suggest sites.
On Feb 28, 2014 3:07 PM, "Ed Christopher" <edc@berwyned.com> wrote:
> I got asked a question today, from a transportation perspective,
> about access to health care and health facilities. As I started to hunt
> around on the web I thought I would throw it out to our Listserve. Does
> anyone know of any research, literature or other articles that they
> could pass along dealing with access to health care services?
>
> Thanks
> --
> Ed Christopher
> _______________________________________________
> H+T--Friends mailing list
> H+T--Friends@chrispy.net
> https://www.chrispy.net/mailman/listinfo/h+t--friends
>
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Message: 4
Date: Fri, 28 Feb 2014 18:58:16 -0800
From: Rajiv Bhatia <rb6419@gmail.com>
Subject: Re: [H+T--Friends] Access to Health Care
To: TRB Health and Transportation <h+t--friends@chrispy.net>
Message-ID: <B6368ACB-B234-45D2-87FB-80F7D05E9F54@gmail.com>
Content-Type: text/plain; charset="us-ascii"
Ed
These are the studies I found in a 2009 review -- i'm sure there are new ones.
1. Ahmed SM, Lemkau JP, Nealeigh N, and Mann B. Barriers to healthcare access in a non-elderly urban poor American population. Health and Social Care in the Community. 2001; 9:445-453.
2. Yang S, Zarr RL, Kass-Hout TA, Kourosh A, Kelly NR. Transportation barriers to accessing health care for urban children. Journal of Health Care for the Poor and Underserved. 2006; 17:928-43.
3. Rust G, Ye J, Baltrus P, Daniels E, Adesunloye B, Fryer GE. Practical barriers to timely primary care access: impact on adult use of emergency department services. Archives in Internal Medicine. 2008; 168:1705-1710.
4. Arcury TA, Preisser JS, Gesler WM, Powers JM. Access to transportation and health care utilization in a rural region. Journal of Rural Health. 2005; 21:31-38.
On Feb 28, 2014, at 12:43 PM, Ed Christopher <edc@berwyned.com> wrote:
> I got asked a question today, from a transportation perspective,
> about access to health care and health facilities. As I started to hunt
> around on the web I thought I would throw it out to our Listserve. Does
> anyone know of any research, literature or other articles that they
> could pass along dealing with access to health care services?
>
> Thanks
> --
> Ed Christopher
> _______________________________________________
> H+T--Friends mailing list
> H+T--Friends@chrispy.net
> https://www.chrispy.net/mailman/listinfo/h+t--friends
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