Cargando…

Effect of interventions for non-emergent medical transportation: a systematic review and meta-analysis

INTRODUCTION: Transportation is an important social determinant of health. We conducted a systematic review of the associations on health and health care utilization of interventions aimed at reducing barriers to non-emergency transportation and non-medical transportation. METHODS: We searched three...

Descripción completa

Detalles Bibliográficos
Autores principales: Shekelle, Paul G., Begashaw, Meron M., Miake-Lye, Isomi M., Booth, Marika, Myers, Bethany, Renda, Andrew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9026972/
https://www.ncbi.nlm.nih.gov/pubmed/35449011
http://dx.doi.org/10.1186/s12889-022-13149-1
_version_ 1784691244752961536
author Shekelle, Paul G.
Begashaw, Meron M.
Miake-Lye, Isomi M.
Booth, Marika
Myers, Bethany
Renda, Andrew
author_facet Shekelle, Paul G.
Begashaw, Meron M.
Miake-Lye, Isomi M.
Booth, Marika
Myers, Bethany
Renda, Andrew
author_sort Shekelle, Paul G.
collection PubMed
description INTRODUCTION: Transportation is an important social determinant of health. We conducted a systematic review of the associations on health and health care utilization of interventions aimed at reducing barriers to non-emergency transportation and non-medical transportation. METHODS: We searched three databases and the gray literature through mid-January 2022. Included studies needed to assess an intervention targeted at non-emergency or non-medical transportation barriers, report missed (or kept) visits, health care utilization, costs, or health outcomes. Data extraction was performed in duplicate and included information about study design, results, and risk of bias. Primary outcomes were frequency of missed appointments, health care utilization, costs, and health outcomes. Synthesis was both narrative and meta-analytic using a random effects model. RESULTS: Twelve studies met inclusion criteria, three randomized trials, one controlled trial, and eight observational studies. All included studies had some element of risk of bias. Populations studied usually had chronic or serious health conditions or were poor. Interventions included van rides, bus or taxi vouchers, ride-sharing services, and others. Meta-analysis of seven studies (three trials, four observational studies) yielded a pooled estimate of missed appointments = 0.63 (95% confidence interval [CI] 0.48, 0.83) favoring interventions. Evidence on cost, utilization, and health outcomes were too sparse to support conclusions. Evidence on the effect of non-medical transportation is limited to a single study. CONCLUSIONS AND RELEVANCE: Interventions aimed at non-emergency transportation barriers to access health care are associated with fewer missed appointments; the association with costs, utilization or health outcomes is insufficiently studied to reach conclusions. This review was registered in PROSPERO as ID CRD42020201875. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-022-13149-1.
format Online
Article
Text
id pubmed-9026972
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-90269722022-04-23 Effect of interventions for non-emergent medical transportation: a systematic review and meta-analysis Shekelle, Paul G. Begashaw, Meron M. Miake-Lye, Isomi M. Booth, Marika Myers, Bethany Renda, Andrew BMC Public Health Research INTRODUCTION: Transportation is an important social determinant of health. We conducted a systematic review of the associations on health and health care utilization of interventions aimed at reducing barriers to non-emergency transportation and non-medical transportation. METHODS: We searched three databases and the gray literature through mid-January 2022. Included studies needed to assess an intervention targeted at non-emergency or non-medical transportation barriers, report missed (or kept) visits, health care utilization, costs, or health outcomes. Data extraction was performed in duplicate and included information about study design, results, and risk of bias. Primary outcomes were frequency of missed appointments, health care utilization, costs, and health outcomes. Synthesis was both narrative and meta-analytic using a random effects model. RESULTS: Twelve studies met inclusion criteria, three randomized trials, one controlled trial, and eight observational studies. All included studies had some element of risk of bias. Populations studied usually had chronic or serious health conditions or were poor. Interventions included van rides, bus or taxi vouchers, ride-sharing services, and others. Meta-analysis of seven studies (three trials, four observational studies) yielded a pooled estimate of missed appointments = 0.63 (95% confidence interval [CI] 0.48, 0.83) favoring interventions. Evidence on cost, utilization, and health outcomes were too sparse to support conclusions. Evidence on the effect of non-medical transportation is limited to a single study. CONCLUSIONS AND RELEVANCE: Interventions aimed at non-emergency transportation barriers to access health care are associated with fewer missed appointments; the association with costs, utilization or health outcomes is insufficiently studied to reach conclusions. This review was registered in PROSPERO as ID CRD42020201875. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-022-13149-1. BioMed Central 2022-04-21 /pmc/articles/PMC9026972/ /pubmed/35449011 http://dx.doi.org/10.1186/s12889-022-13149-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visithttp://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Shekelle, Paul G.
Begashaw, Meron M.
Miake-Lye, Isomi M.
Booth, Marika
Myers, Bethany
Renda, Andrew
Effect of interventions for non-emergent medical transportation: a systematic review and meta-analysis
title Effect of interventions for non-emergent medical transportation: a systematic review and meta-analysis
title_full Effect of interventions for non-emergent medical transportation: a systematic review and meta-analysis
title_fullStr Effect of interventions for non-emergent medical transportation: a systematic review and meta-analysis
title_full_unstemmed Effect of interventions for non-emergent medical transportation: a systematic review and meta-analysis
title_short Effect of interventions for non-emergent medical transportation: a systematic review and meta-analysis
title_sort effect of interventions for non-emergent medical transportation: a systematic review and meta-analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9026972/
https://www.ncbi.nlm.nih.gov/pubmed/35449011
http://dx.doi.org/10.1186/s12889-022-13149-1
work_keys_str_mv AT shekellepaulg effectofinterventionsfornonemergentmedicaltransportationasystematicreviewandmetaanalysis
AT begashawmeronm effectofinterventionsfornonemergentmedicaltransportationasystematicreviewandmetaanalysis
AT miakelyeisomim effectofinterventionsfornonemergentmedicaltransportationasystematicreviewandmetaanalysis
AT boothmarika effectofinterventionsfornonemergentmedicaltransportationasystematicreviewandmetaanalysis
AT myersbethany effectofinterventionsfornonemergentmedicaltransportationasystematicreviewandmetaanalysis
AT rendaandrew effectofinterventionsfornonemergentmedicaltransportationasystematicreviewandmetaanalysis