162057 Transportation as a barrier child health access: The scope of the problem

Tuesday, November 6, 2007: 2:30 PM

Roy Grant, MA , The Children's Health Fund, New York, NY
Arturo Brito, MD , The Children's Health Fund, New York, NY
Jeff Muschell, ME, MPH , The Children's Health Fund, New York, NY
Mark Burton, PhD , University of Tennessee - Knoxville, Center for Transportation Research, Knoxville, TN
Dennis Johnson , The Children's Health Fund, New York, NY
Most discussions of barriers to accessing health care for medically underserved children focus on health insurance. Non-economic barriers, e.g., workforce distribution and transportation, are less often addressed. Historically and currently, there are too few healthcare providers in rural communities. In these “health professional shortage areas” (HPSAs), it is necessary to travel long distances to see a doctor. To quantify the extent of the problem of transportation as a barrier to child health access, we developed, with the Marist Institute for Public Opinion, a survey instrument and administered it to a nationally representative sample (N=1,819) in September 2006. Results: Public transportation is least available in rural communities, with 75% reporting no transport resources vs. 9% in big cities and 27% in suburbs. Only 23% with transport access used it regularly. Reasons for non-use included problems with route, schedule, and reliability. Nationally, 35% of parents must travel ten or more miles to get pediatric care, 7% routinely used the emergency room for acute care; and 4% missed at least one health appointment because of transportation. Of those missing a health appointment because of transportation, most missed two or more per year. One third later required emergency room care for the condition involved. Applied to 2002 Census data, nationally nearly 3 million children miss at least one healthcare appointment each year because of transportation restrictions, associated with up to 1 million preventable ER visits. Using MEPS cost data, the savings in ER visits alone attributable to enhanced transport access could be $75 million/year.

Learning Objectives:
At the end of this presentation, participants will: 1. Better understand the degree to which non-emergency transportation is a barrier to healthcare access for children across the country; 2. Better understand how transportation restrictions contribute to access problems in rural communities; 3. Understand the cost-effectiveness of enhancing access to non-emergency medical transportation

Keywords: Access, Underserved Populations

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.