SRFP047: Free Bus Tickets aim to reduce no-shows by addressing transportation barriers

Kento Sonoda, MD, AAHIVS; Cynthia Salter, PhD, MPH; Lindsay Nakaishi, MD, MPH

Abstract

Context: Missed medical appointments without cancellation (no-shows) negatively affect the flow of patient care and clinic productivity. Limited evidence is available about effective interventions to reduce no-show appointments by addressing patient transportation barriers. Objective: 1) explore patient response to free bus tickets for medical appointments, 2) identify other factors contributing to no-show appointments. Study Design: Prospective cohort and mixed methods study. Setting: October 2020-July 2021 at an urban ambulatory family health center. Population Studied: Eligible participants included patients who presented to the community health center for any type of medical appointments, who consented to answer a brief qualitative questionnaire and who screened positive for transportation issues. Two standardized screening questions: Has lack of transportation interrupted medical needs in the past 12 months? Has lack of transportation interrupted daily activities in the past 12 months. Intervention: Participants received two free bus tickets to defer transportation costs. Outcome Measures: Main) Patient perceptions of ticket usefulness. Secondary) Themes of other contributing factors for no-shows. Results: 108 patients participated in this study, and 88.9 % (96/108) of participants reported having a bus ticket helps them keep medical appointments; 82.4 % (89/108) reported having a bus ticket influences their decision to come to the health center. Of those who have missed prior appointments without cancellation, 71.7 % (38/53) reported transportation issues as potential factors contributing to no-shows. Finances was the second most common self-reported theme: 18.9 % (10/53). Comments from participants: “If I cannot get a ride, sometimes I will cancel.”, “The bus tickets help me a lot.”, “I think it’s a great and very helpful thing. Getting transportation is not easy.”, “This is a good thing to do. Thank you.”, “I usually walk. Having bus tickets helps me a lot.” Conclusions: This study provides insight into patient experiences related to no-show appointments. Free bus tickets can reduce no-shows by addressing patient financial or/and transportation issues for coming to the health center. The effect of travel assistance on no-show rates among patient populations at a community center should be further explored. This study was impacted by the COVID-19 pandemic regarding the fear of the public transportation and increased telemedicine visits.
Leave a Comment
Judy Belle Brown
jbbrown@uwo.ca 11/20/2021

Fabulous work. How something so simple as a few bus tickets can improve access, reduce no shows and hopefully improve care!! Thanks!

Kento Sonoda
11/22/2021

Thank you very much. Exactly. Simple is the best although no-show involves complex and multi-factorial situations. 

Jack Westfall
jwestfall@aafp.org 11/21/2021

This is a great topic and research study. Nice work. Thanks

Kento Sonoda
11/22/2021

Thank you very much for your comment and checking our poster. 

Gillian Bartlett
gillian.bartlett@health.missouri.edu 11/21/2021

Great work - interesting implications for our discussions on EDI and climate impact!

Kento Sonoda
11/22/2021

Thank you very much. 

William R. Phillips
wphllps@uw.edu 11/21/2021

Great poster on an interesting approach to an important and very common problem. Simple solutions are often the best solutions. If you pursue larger research on this type of transportation intervention, you might consider integrating GIS data and bus routes to help address differences between patients in her and how easy this is a bus with her without a free ticket it is doable; talk to your colleagues in geography and urban planning.. - Bill Phillips

Kento Sonoda
sonodak@upmc.edu 11/23/2021

Thank you for your suggestions on future directions. That sounds a great idea to me. Thank you so much. 

Diane Harper
harperdi@med.umich.edu 11/22/2021

how did you pay for this in the sustenance mode? Thank you for sharing your work with NAPCRG!

Kento Sonoda
sonodak@upmc.edu 11/23/2021

This project was funded by UPMC Shadyside Hospital Foundation. We received another one in this academic year to continue our project to address transportation barriers. Hope I answered your question. Thank you for this great opportunity to share our scholarly work. 

Andy Pasternak
avpiv711@sbcglobal.net 11/26/2021

Well done!

Andy Pasternak
avpiv711@sbcglobal.net 11/26/2021

Sorry- got cut off. A big issue, however is making sure the practice is on a bus line. Our office is but I know many offices that aren't.

Social Media

Address

NAPCRG
11400 Tomahawk Creek Parkway
Leawood, KS 66211
800.274.7928
Email: napcrgoffice@napcrg.org