Rideshare-based transportation services for surgical patients in an urban setting: A descriptive analysis of a quality initiative program

Abstract

IntroductionTransportation access is a social determinant of health that hinders chronic care engagement for vulnerable populations. Few studies have examined how transportation interventions impact healthcare outcomes when implemented independently of other tailored interventions (i.e., multicomponent outreach programs). Data is further limited for rideshare initiatives. MethodsWe conducted a retrospective, descriptive analysis of a rideshare-based transportation program for pre- and post-operative patients as part of a quality improvement (QI) initiative at a San Francisco County hospital. We assessed the population benefiting from this rideshare program and compared outcomes between program participants and non-participants. Data obtained included sociodemographic information, effects of health care utilization (e.g., delays in the operating room (OR)), and hospital rideshare costs. ResultsOverall, $18,733 in funds were used to fully subsidize 1562 Lyft rides for patients traveling to and from the hospital. Inclusion criteria resulted in 4150 total patients, with 376 in the rideshare group and 3774 in the non-rideshare group. Rideshare group patients were more likely to be older, male, black/African American, less healthy per physical status classification ratings, and residing in neighborhoods with lower income. Non-rideshare group patients were more likely to be Hispanic/Latino and require interpreter use. The patients participating in the rideshare program had non-significant increases in the proportion of OR cases delayed (48.2% and 44.1%, respectively) and average time delayed in OR case start times (18.7 and 14.6 min, respectively) compared to the non-rideshare group. The average cost per Lyft ride to the first scheduled surgery of the day was $15.13. ConclusionsWhile rideshare programs may not decrease the rates or magnitude of OR delays, they can address transportation barriers for vulnerable communities, and likely at a minimal financial burden to the healthcare system. Future work is required to examine potential health benefits from transportation interventions, particularly those based in rideshare initiatives.