Non-Emergency Medical Transportation Needs of Middle-Aged and Older Adults: A Rural-Urban Comparison in Delaware, USA

Matthew Lee Smith, Thomas R. Prohaska, Kara E. MacLeod, Marcia G. Ory, Amy R. Eisenstein, David R. Ragland, Cheryl Irmiter, Samuel D. Towne and William A. Satariano
Additional contact information
Matthew Lee Smith: College of Public Health, The University of Georgia, Athens, GA 30602, USA
Thomas R. Prohaska: College of Health and Human Services, George Mason University, Fairfax, VA 22030, USA
Kara E. MacLeod: Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA
Marcia G. Ory: Texas A&M School of Public Health, Texas A&M University, College Station, TX 77844, USA
Amy R. Eisenstein: Feinberg School of Medicine, Northwestern University, Chicago, IL 60209, USA
David R. Ragland: School of Public Health, University of California, Berkeley, CA 92521, USA
Cheryl Irmiter: Easter Seals, Chicago, IL 91106, USA
Samuel D. Towne: Texas A&M School of Public Health, Texas A&M University, College Station, TX 77844, USA
William A. Satariano: School of Public Health, University of California, Berkeley, CA 92521, USA

IJERPH, 2017, vol. 14, issue 2, 1-13

Abstract: Background : Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas. Methods : Data were analyzed from 39,194 NEMT users of LogistiCare-brokered services in Delaware residing in rural (68.3%) and urban (30.9%) areas. Multivariable logistic analyses compared trip characteristics by rurality designation. Results : Rural (37.2%) and urban (41.2%) participants used services more frequently for dialysis than for any other medical concern. Older age and personal accompaniment were more common and wheel chair use was less common for rural trips. The mean cost per trip was greater for rural users (difference of $2910 per trip), which was attributed to the greater distance per trip in rural areas. Conclusions : Among a sample who were eligible for subsidized NEMT and who utilized this service, rural trips tended to be longer and, therefore, higher in cost. Over 50% of trips were made for dialysis highlighting the need to address prevention and, potentially, health service improvements for rural dialysis patients.

Keywords: rural; non-emergency medical transportation; transportation; travel distance; healthcare access; United States of America; aging (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2017
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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