452 - Transportation Access and Insecurity: A Driving Factor in Healthcare Equality
Saturday, April 29, 2023
3:30 PM – 6:00 PM ET
Poster Number: 452 Publication Number: 452.219
Sarah Marakos, Inova Children’s Hospital, Centreville, VA, United States; Lauren Clopper, Inova Children's Hospital, McLean, VA, United States; Jean He, Inova Children's Hospital, Fairfax, VA, United States; Courtney Port, Inova Children's Hospital, Falls Church, VA, United States; Henna Qureshi, Inova Children's Hospital, falls church, VA, United States
Pediatric Resident, PGY-2 Inova Children’s Hospital Centreville, Virginia, United States
Background: Each year, 3.6 million people in the United States do not obtain medical care due to transportation issues. Transportation access is now realized as a social determinant of health by the American Hospital Association. Not only does transportation insecurity create an obstacle to obtaining care, but it also results in missed/delayed health appointments, increased health expenditures, and poor health outcomes/increased hospitalization. With this in mind, we intended to assess the need for transportation aid in our local community. Objective: The primary aim of this study is to obtain baseline data on transportation needs and the resources currently used by the individuals in our local, safety net clinic in Northern Virginia. Design/Methods: To reach this goal, we provided a survey in both English and Spanish to individuals in our clinic. The survey was handed out by front desk employees to willing patients and families as they waited for their appointments over the course of 8 weeks. We screened individuals on various aspects of transportation, including their mode of transportation, missed medical appointments due to transportation, cost, and time. Results: We collected surveys on 87 families within our clinic. In our survey we found that 37.9% (n=33) of individuals do not have access to their own transportation. Of these, 59% use ride-sharing (n=9), such as Uber and Lyft, or Raiteros (n=11), drivers who transport groups of low-wage workers to their jobs for a fee. Only 2 families (6%) reported using insurance provided transportation. 28.7% (n=25) of patients reported missing an appointment in the past year due to a transportation issue. The mean cost of transportation was $25.58 (std dev $18.16) and the mean transportation time was 23.2 minutes (std dev 12.6 min). Those families without a vehicle were more likely to find it difficult to get to the clinic (p=.006).
Conclusion(s): Consistent with prior research, a large percent of our clinic patients do not have access to reliable transportation. We now plan to start screening at all well child checks with a tool built into our EMR system. A positive screen will trigger patients to receive additional resources on transportation aid, which include insurance backed transport, public transit information, and existing community partnerships with rideshares.
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