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Archive of posts published in the category: barriers

Transportation Barriers to Health Care Access

Ahmed et al. [1] N = 413 adults
Urban (Dayton, Ohio), low SES 71 % female, 48 % Black, 42 % Appalachian Door to door survey on barriers to health care access “Difficulty finding transportation” (1) “Hard” or “very hard” time finding transportation (31 %) Arcury et al. [37] N = 1,059 adults
Rural (North Carolina), mixed SES, 662 female, 948 Whites, 112 Blacks Retrospective, comparing transportation barriers and health care utilization “Distance to care for… regular visit… for less serious emergency… for serious emergency” (3)
Has a driver’s license, any household member has a driver’s license, number of vehicles owned in household, days per week spent driving, relative or friend who regularly provides transportation for a family member, knowledge of organizations that provided transportation to health care and use of such transportation (7) Health care utilization associated with having a driver’s license (OR 2.29 more visits) and having a friend or relative who provides transportation (OR 1.58 more visits) Blazer et al. [14] N = 4,162 adults, age 65 +
Rural/Urban North Carolina), mixed SES, 62 % female, 68 % Non-Black (majority White) Retrospective cross-sectional survey (1986/87) analyzed for urban/rural variation of health service use, satisfaction, barriers to care Do you put off or neglect going to the doctor because of “distance or transportation”? (1) No difference between urban and rural residents in health service use; 7.7 % delayed care due to distance or transportation Borders et al. [54] N = 2,097 adults, age 65 +
Rural (West Texas), mixed SES 71 % female, 1949 Non-Hispanic, 148 Hispanic Telephone survey on barriers to health care access “Always/usually get transportation to doctor’s office” (1) Non- Hispanics (96 %) vs. Hispanics (90 %) could usually get transportation to clinic Branch et al. [36] N = 776 adults, age 65 +
Massachusetts, 95 % Medicare, 17 % Medicaid, 61 % privately insured, 64 % female Race not reported Retrospective survey interviews on barriers to health care access “You did not have a way to travel to the doctor” (1) Not having a way to get to the doctor (3 %); travel difficulties associated with lower income, being female, living alone, having less education Call et al. [56]b N = 1,853 Minnesota Health Care Plan adult and parent enrollees
Minnesota, 65 % female adult enrollees, 47 % female parent enrollees, 1,314 Whites, 539 American Indians Mailed survey on barriers to health care access “Difficulties with transportation” (1) American Indians (39 %) vs. Whites (18 %) have difficulties with transportation Canupp et al. [49] N = 163 adults, mean age 26 with spinal cord injuries
Birmingham, Alabama, 25 % had income greater than 25,000 dollars, 14 % female, 63 % white Face to face survey on barriers to follow- up appointments Obstacles for follow-up included distance to travel and availability of transportation (2) Non-compliance with appointments associated with distance to travel (P = 0.004) and availability of transportation (P = 0.033) Crain et al. [15]b N = 1,376 caretakers of

Traveling towards disease: transportation barriers to health care access. – PubMed

Transportation barriers are often cited as barriers to healthcare access. Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. These consequences may lead to poorer management of chronic illness and thus poorer health outcomes. However, the significance of these barriers is uncertain based on existing literature due to wide variability in both study populations and transportation barrier measures. The authors sought to synthesize the literature on the prevalence of transportation barriers to health care access. A systematic literature search of peer-reviewed studies on transportation barriers to healthcare access was performed. Inclusion criteria were as follows: (1) study addressed access barriers for ongoing primary care or chronic disease care; (2) study included assessment of transportation barriers; and (3) study was completed in the United States. In total, 61 studies were reviewed. Overall, the evidence supports that transportation barriers are an important barrier to healthcare access, particularly for those with lower incomes or the under/uninsured. Additional research needs to (1) clarify which aspects of transportation limit health care access (2) measure the impact of transportation barriers on clinically meaningful outcomes and (3) measure the impact of transportation barrier interventions and transportation policy changes.

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