Traveling Towards Disease: Transportation Barriers to Health Care Access

Abstract

Transportation barriers are often cited as barriers to healthcare access. Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. These consequences may lead to poorer management of chronic illness and thus poorer health outcomes. However, the significance of these barriers is uncertain based on existing literature due to wide variability in both study populations and transportation barrier measures. The authors sought to synthesize the literature on the prevalence of transportation barriers to health care access. A systematic literature search of peer-reviewed studies on transportation barriers to healthcare access was performed. Inclusion criteria were as follows: (1) study addressed access barriers for ongoing primary care or chronic disease care; (2) study included assessment of transportation barriers; and (3) study was completed in the United States. In total, 61 studies were reviewed. Overall, the evidence supports that transportation barriers are an important barrier to healthcare access, particularly for those with lower incomes or the under/uninsured. Additional research needs to (1) clarify which aspects of transportation limit health care access (2) measure the impact of transportation barriers on clinically meaningful outcomes and (3) measure the impact of transportation barrier interventions and transportation policy changes.

Benefits of health reform for households in rural South Africa following implementation of ward-based primary healthcare outreach teams: a qualitative inquiry

“…This practise has been reported in other studies where CHWs donated personal resources in order for their patients to maintain their treatment and the relationships they have established with the households [13]. Opportunity costs, mainly transport costs, are common barriers to healthcare access, and often lead to missed appointments, delayed or missed health care [30]. Evidence from other studies show that once PHC is not accessible or effective, people delay seeking help, rely on emergency care, and lose the benefits of continuity of care [29].…”

Asthma and Food Allergy Management in Chicago Public Schools

“…5,[26][27][28][29][30][31][32] Additionally, it is unclear whether socioeconomic and racial variability in food allergy is intrinsic to the disease verification process; however, many have speculated that it is attributable, in least at part, to barriers to care among racial/ ethnic minorities and disadvantaged households. [33][34][35][36][37] Additionally, this study determined that students attending school on the city' s North-Northwest Side were significantly more likely to have a school health management plan on file than students from any other region of Chicago. These findings speak to the general racial/ ethnic and socioeconomic segregation of the city, as well as limitations in access to care, which likely impact documentation of chronic disease and access to school health management plans in CPS.…”

A descriptive qualitative study of childhood cancer challenges in South Africa: Thematic analysis of 68 photovoice contributions

“…47 In this study, most of the childhood patients with cancer (77%) had to travel far away from home for treatment and the separation of families was an onerous challenge. Practical transport challenges included long waits (even sleeping overnight on benches or on the floor) for pickup, harsh travel conditions, difficulties with bookings, costs, struggles accessing information and frustration with rectifying problems.…”