Oral

Most discussions of barriers to access to healthcare for low-income children focus on economic factors such as health insurance. As important as health insurance is to facilitating health access, it is not enough. There are also powerful non-economic barriers to access including the maldistribution of health resources, which typically leaves many rural communities without an adequate supply of health professionals. Especially in rural Health Professional Shortage Areas (HPSAs), families must travel considerable distances to get to a doctor. These communities also typically have high poverty rates and very limited public transportation services, creating significant barriers to access. This presentation will discuss the issue of transportation as a non-economic barrier to healthcare access from several points of view. We will begin with new data quantifying the extent of this problem using data from a national telephone survey. This will include a cost estimate of the impact of missed appointments. Next we will look at how states are dealing with transportation as an enabling health service in Medicaid and SCHIP. Our next presenter will describe strategies to increase existing transportation system utilization through improved coordination between transportation providers, medical facilities, and responsible government entities. Finally we will describe several pilot programs now being implemented to improve transportation access to primary healthcare services in rural communities in Arkansas and Mississippi.

Session Objectives: At the end of this session, participants will be better able to: • Discuss the role of transportation as a non-economic barrier to access of non-emergency medical care • Quantify the extent to which transportation barriers are associated with excess use of hospital emergency rooms for non-urgent care and increased healthcare costs • Describe why access to healthcare in rural communities are especially affected by transportation restrictions • Discuss the utility of improving collaboration between local level transportation and healthcare providers to coordinate existing resources

CE Credits: CME, Health Education (CHES), Nursing