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Int. J. Environ. Res. Public Health 2017, 14(2), 174; doi:10.3390/ijerph14020174

Non-Emergency Medical Transportation Needs of Middle-Aged and Older Adults: A Rural-Urban Comparison in Delaware, USA

1
College of Public Health, The University of Georgia, Athens, GA 30602, USA
2
Texas A&M School of Public Health, Texas A&M University, College Station, TX 77844, USA
3
College of Health and Human Services, George Mason University, Fairfax, VA 22030, USA
4
Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA
5
Feinberg School of Medicine, Northwestern University, Chicago, IL 60209, USA
6
School of Public Health, University of California, Berkeley, CA 92521, USA
7
SafeTREC, University of California, Berkeley, CA 92521, USA
8
Easter Seals, Chicago, IL 91106, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 9 December 2016 / Revised: 17 January 2017 / Accepted: 25 January 2017 / Published: 10 February 2017
(This article belongs to the Special Issue Aging and Health Promotion)
View Full-Text   |   Download PDF [622 KB, uploaded 10 February 2017]   |  

Abstract

Background: Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas. Methods: Data were analyzed from 39,194 NEMT users of LogistiCare-brokered services in Delaware residing in rural (68.3%) and urban (30.9%) areas. Multivariable logistic analyses compared trip characteristics by rurality designation. Results: Rural (37.2%) and urban (41.2%) participants used services more frequently for dialysis than for any other medical concern. Older age and personal accompaniment were more common and wheel chair use was less common for rural trips. The mean cost per trip was greater for rural users (difference of $2910 per trip), which was attributed to the greater distance per trip in rural areas. Conclusions: Among a sample who were eligible for subsidized NEMT and who utilized this service, rural trips tended to be longer and, therefore, higher in cost. Over 50% of trips were made for dialysis highlighting the need to address prevention and, potentially, health service improvements for rural dialysis patients. View Full-Text
Keywords: rural; non-emergency medical transportation; transportation; travel distance; healthcare access; United States of America; aging rural; non-emergency medical transportation; transportation; travel distance; healthcare access; United States of America; aging
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MDPI and ACS Style

Smith, M.L.; Prohaska, T.R.; MacLeod, K.E.; Ory, M.G.; Eisenstein, A.R.; Ragland, D.R.; Irmiter, C.; Towne, S.D.; Satariano, W.A. Non-Emergency Medical Transportation Needs of Middle-Aged and Older Adults: A Rural-Urban Comparison in Delaware, USA. Int. J. Environ. Res. Public Health 2017, 14, 174.

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