Cost-Benefit Analysis of Providing Non-Emergency Medical Transportation (2005) / Chapter Skim
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Executive Summary Millions of Americans are considered to be "transportation disadvantaged," because they cannot provide or purchase their own transportation. As a result, this population -- which is disproportionately elderly, poor, mobility-impaired, minority, or some combination of these -- depends on others to access employment, education, shopping, and healthcare.
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Summary of Results An analysis of nationally representative healthcare datasets revealed that about 3.6 million Americans miss or delay non-emergency medical care each year because of transportation issues. This target population of 3.6 million persons was found to have a higher prevalence of chronic diseases and a higher rate of multiple chronic conditions.
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specific conditions as either highly or moderately cost-effective, with the former referring to costs far less than $50,000 per QALY and the latter referring to costs closer to $50,000 per QALY. Using two approaches -- one for chronic conditions amenable to disease management and one for conditions amenable to preventive care -- the researchers were able to determine reasonable healthcare cost differences between well and poorly managed care.
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Figure ES-1: Transportation-Disadvantaged Population at Risk of Missing Non-Emergency Care TransportationDisadvantaged Persons Transportationdisadvantaged persons who missed nonemergency medical care Transportation-disadvantaged persons who found transportation from a source that is not always available – a friend, acquaintance, family member, etc. Transportation-disadvantaged persons who found transportation from a source that is not always available – a friend, acquaintance, family member, etc.
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Selection of Health Conditions for the Analysis The examined diseases were drawn from the prevalence data in NHIS and MEPS. While there is clear value in a condition-by-condition approach for evaluating the costs and benefits of providing transportation to transportation-disadvantaged individuals, there is an obvious trade-off between the number of conditions that are evaluated and the quality of these analyses.
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locations. Although persons who are ambulatory could, in theory, access fixed-route transportation, the research suggests that those who actually have such access are or could be using it to obtain medical care.
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