Effects of an urban light rail line on health care utilization and cost: A pre-post assessment

Richard T. Meenan, Lawrence D. Frank, Brian E. Saelens, Deborah R. Young, Jennifer L. Kuntz, John F. Dickerson, Behram Wali, Erin M. Keast and Stephen P. Fortmann

Transport Policy, 2022, vol. 123, issue C, 112-120

Abstract: In September 2015, a new light rail transit (LRT) line opened in metro Portland, Oregon, USA. We used this natural experiment to conduct an interrupted time series analysis of the effects of LRT introduction on health care costs. We hypothesized that such costs would decline over time based on demonstrated health benefits of increased transit-related physical activity. We wanted to evaluate whether introducing new LRT would lower the trajectory of monthly health care costs generated by a large sample of members of an integrated health care plan living near a new LRT station (cases) relative to similar members who did not (controls). We hypothesized that new LRT would stimulate higher transit use and consequently, higher transit-related physical activity among plan members living relatively closer to the LRT. However, the new LRT did not lower health care costs as hypothesized, at least relative to prior costs and within the first 4.5 years after the LRT opening. Results were consistent across outpatient visit costs and medication costs, as well as when only the 10 percent most expensive health plan members were considered. Although we did not find evidence of transit-related reductions in health care costs, research into the potential influence of public transit on physical activity and downstream health care costs remains warranted. Mechanisms through which such influence manifests are complex. Our negative results based on extensive and objectively measured health care cost data will contribute to the accuracy and validity of future models of the societal benefits of public transit.

Keywords: Public transit; Light rail; Health care cost; Physical activity; Preventive health (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
http://www.sciencedirect.com/science/article/pii/S0967070X22001305
Full text for ScienceDirect subscribers only

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:eee:trapol:v:123:y:2022:i:c:p:112-120

Ordering information: This journal article can be ordered from
http://www.elsevier.com/wps/find/supportfaq.cws_home/regional
https://shop.elsevie ... _01_ooc_1&version=01

DOI: 10.1016/j.tranpol.2022.05.005

Access Statistics for this article

Transport Policy is currently edited by Y. Hayashi

More articles in Transport Policy from Elsevier
Bibliographic data for series maintained by Catherine Liu ().