Lack of reliable transportation
can be a barrier to keeping appointments or accessing other health care services. Increasingly, insurers and health care delivery systems subsidize transportation
services for patients. This systematic review synthesizes existing research on nonemergency medical transportation
We searched 3 databases (Embase, PubMed, Google) for studies of health care sector-sponsored programs that provided patients assistance with nonemergency transportation
and directly assessed the impact of transportation
assistance on health and health care utilization outcomes. Studies meeting inclusion criteria were graded for quality using standard grading criteria.
Eight studies met all inclusion criteria. Most were rated as low quality. All studies included examined process or health care utilization outcomes, such as uptake of transportation
services, return for follow-up, or missed appointment rates; only 1 included health outcomes, such as illness severity and blood pressure. Results were mixed. More rigorous studies showed low patient uptake of transportation
services and inconsistent impacts on health and utilization outcomes.
Despite considerable interest in subsidizing transportation
services to improve health for patients facing transportation
barriers, little rigorously conducted research has demonstrated the impact of transportation
services on health or health care utilization. Some extant literature suggests that transportation
assistance is more likely to be effective when offered with other interventions to reduce social and economic barriers to health.