- Hospitals play an important role in addressing transportation barriers, patient care access, and other social determinants of health, according to a recent report from the American Hospital Association.
The AHA paper, “Transportation and the Role of Hospitals,” is part of the organization’s series on the social determinants of health, which are social factors that impact health outside the four walls of the hospital. These issues have a larger impact on patient wellness than genetics or health factors.
“Health and well-being are inextricably linked to the social and economic conditions in which people live,” AHA explained. “Research has shown that only 20 percent of health can be attributed to medical care, while social and economic factors—like access to healthy food, housing status, educational attainment and access to transportation—account for 40 percent.”
Currently, 3.6 million individuals do not access medical care because they experience transportation barriers, and 4 percent of all children miss a medical appointment because of transportation issues. Transportation barriers are the third leading cause of missing a medical appointment for seniors across the country, AHA noted.
Transportation barriers can also limit individuals to varying degrees. An individual who does not have transportation access and has a physical impairment is more limited than an individual without a car but who can ride a bike to the hospital, for example.
Common transportation barriers include long travel distances, lack of vehicle, transportation cost, inadequate infrastructure, and adverse policies affecting travel. Each of these obstacles can keep a patient from accessing her providers, which in turn could impair overall health.
“Transportation barriers can affect a person’s access to health care services,” AHA explained. “These barriers may result in missed or delayed health care appointments, increased health expenditures and overall poorer health outcomes.”
Efforts to overcome transportation barriers can also serve as health enablers, the organization noted. While some efforts should focus on ridesharing solutions and better public transportation, communities can also look into building walkable areas, bike sharing, and bike lanes. These efforts will improve patient wellness and increase physical activity among patient populations.
Hospitals are in an ideal position to spark changes in transportation, AHA asserted. Hospitals are pillars of the community, and can help facilitate change by leveraging their community relationships.
“Although hospitals and health systems traditionally have not focused on transportation issues within their purview of care delivery, there is a growing recognition that improving transportation access and support for patients can help improve health outcomes and lower health costs,” AHA noted.
Additionally, when hospitals support transportation improvements, they may improve their financial bottom line by reducing the number of no-show appointments and the rate of medication non-adherence, a very costly healthcare issue.
There is no singular cure-all solution for hospitals to overcome transportation needs, AHA advised. Transportation programs will be varied across regions, but must remain targeted on unique area needs.
Hospitals can begin designing transportation solutions by looking over their community health needs assessments and integrating transportation needs into organization strategic plans. Hospitals should also evaluate and note individual patient transportation needs.
From there, hospitals can partner with community organizations and other stakeholders to provide direct transportation services. Healthcare institutions can also support policy and infrastructure changes that create safer transportation access.
Efforts should conclude with hospital leaders educating staff about transportation needs and by creating better patient outreach programs that promote transportation options.
Lack of transportation can also exacerbate other social determinants of health, AHA argued. For example, individuals who cannot get from one place to another likely cannot easily access a grocery store, creating food insecurity. Transportation to and from work and school can also lead to other social health issues.
Although overcoming transportation challenges will be a community-wide effort, AHA contends that the hospital must be at the cornerstone of all efforts. There are significant health and financial implications for supporting patient transportation needs. Creating solutions to these problems can help improve patient health by offering healthier transportation options and facilitating better patient access to care.
“By making the commitment to address transportation barriers and building partnerships with community organizations and other entities, hospitals and health systems can improve transportation and health care access for patients and families and create more equitable, healthier communities,” the report concluded.
This report was published as a part of AHA’s series on the social determinants of health. Earlier this year, AHA released a report about overcoming housing security challenges and how organizations can play a role in reducing homelessness.