271329 Utilization and cost of non-emergency medical transportation among older adults: A rural-urban comparison

Tuesday, October 30, 2012 : 1:18 PM - 1:30 PM

Matthew Lee Smith, PhD, MPH, CHES , Department of Health Promotion and Behavior, The University of Georgia, College of Public Health, Athens, GA
Thomas Prohaska, PhD , School of Public Health, University of Illinois at Chicago, Chicago, IL
Amy Eisenstein, PhD , Buehler Center on Aging, Health & Society, Northwestern University Feinberg School of Medicine, Chicago, IL
David R. Ragland, PhD, MPH , Safe Transportation Research & Education Center (SafeTREC), University of California Berkeley, Berkeley, CA
William Satariano, PhD , School of Public Health, University of California, Berkeley, Berkeley, CA
Rural elderly have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. These transportation barriers can hinder older adults from obtaining needed healthcare and foster negative health outcomes. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs for older adults in rural versus urban areas. Data were analyzed from 39,194 NEMT users of Logisticare-brokered services for Oklahoma in 2010 residing in rural (68.3%) and urban (30.9%) areas. Bivariate analyses compared study variables by rurality designation. Rural NEMT users were older than urban users, with 9.8% and 7.3% age 75 and older, respectively. Rural NEMT users were more likely to use ambulatory and less likely to use wheelchair transportation assistance. No significant difference was observed in the number of trips scheduled. Rural (37.2%) and urban (41.2%) participants used services more frequently for dialysis than for any other medical concern. The mean cost per trip was greater for rural users (difference of $2,910 per year), which was attributed to the greater distance per trip in rural areas. Brokered NEMT services provide a critical link to accessing medical care services for older rural adults. NEMT targets low income older adults who lack alternative transportation options, which is more predominant in rural settings. Although NEMT service use in rural areas is more costly, NEMT provides necessary services to older adults at high risk for adverse health outcomes in the absence of other viable transportation options.

Learning Areas:
Diversity and culture
Provision of health care to the public

Learning Objectives:
1. Identify three characteristics associated with the utilization of non-emergency medical transportation (NEMT) among rural-residing older adults in Delaware and Oklahoma. 2. Describe three characteristics related to NEMT costs among rural-residing older adults in Delaware and Oklahoma. 3. Discuss two implications for interventions in terms of addressing NEMT travel issues in rural communities serving older adults.

Keywords: Rural Health, Health Care Access

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a public health researcher and educator for over a decade. Much of my research and service efforts target the unique health issues in rural areas.
Any relevant financial relationships? No

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.