Evidence to support the need to educate physicians and healthcare professionals about non-emergency medical transportation

Cognitive impairment or degenerative chronic conditions often require older adults (OAs) to cease driving, yet it is unclear which OA subgroups need non-emergency medical transportation (NEMT) services, and how this need is addressed by healthcare providers. Findings from two studies will be presented regarding (a) when OAs are likely to need transportation services and (b) physician confidence to assess, counsel, and address transportation needs for OAs. The first study utilized 2010 data from Delaware statewide brokered transportation services. Among the 16,195 NEMT Delaware users, 2,467 are age 65 and older. The majority of trips for older NEMT users were: (1) ambulatory (58.3%), but this type of service decreased with age; and (2) patients requiring dialysis (67%, n=22,368 trips) with older women more likely to use NEMT for dialysis treatment than older men. Almost 11% of OAs used NEMT for mental health services, although almost none of these trips were for individuals aged 75+. The second study examined the impact of an educational program to help healthcare providers council older drivers (ODs) about driving cessation. Upon completion of the program, self-efficacy to assess, counsel and treat ODs about driving retirement and options improved among 93% of the providers. Additionally, 90% increased their knowledge and level of confidence about OA driving and laws. These concurrent findings suggest there are opportunities for healthcare professionals to better understand transition options and provide referrals for OA subgroups to use NEMT for specific health issues.