The Road to Access: Addressing Transportation Challenges in Rural Primary Care

Area of Science:

• Public Health
• Health Services Research
• Rural Health

Background:

• Central Appalachia faces significant health disparities linked to social determinants like poverty and isolation.
• Transportation barriers exacerbate these disparities, limiting access to essential healthcare services.

Purpose of the Study:

• To evaluate the health and financial impact of transportation barriers on primary care access for patients at a rural federally qualified health center (FQHC).
• To identify how these barriers affect healthcare utilization patterns and costs.

Main Methods:

• Conducted two patient surveys at a rural FQHC in Central Appalachia.
• Analyzed patient reliance on emergency services and hospitalization in relation to transportation barriers.
• Examined financial costs associated with transportation for healthcare appointments.

Main Results:

• Patients with transportation barriers disproportionately use emergency department (ED) services and require hospitalization.
• Medicaid beneficiaries, despite eligibility for non-emergency medical transportation (NEMT), often pay for transport to appointments.
• Financial strain from transportation costs correlates with increased ED visits and hospitalizations, especially for Medicaid beneficiaries.

Conclusions:

• Investing in non-emergency medical transportation (NEMT) services can mitigate healthcare spending by reducing reliance on costly emergency care and hospitalizations.
• Enhanced NEMT services have the potential to improve equitable access to primary care for vulnerable rural populations.
• Addressing transportation barriers is crucial for reducing health disparities in underserved regions like Central Appalachia.