Ronetta Stokes is a utilization reviewer for inpatient psychiatry at a Connecticut hospital. Ronetta shared some observations with us regarding the patient transportation problems she’s seen when people are discharged from an inpatient mental health center.
“In my role at my local hospital, I notice many patients at discharge do not have transportation to get home. It’s a patient transportation problem that has been brought up many times.”
Making quality, reliable transportation available to patients isn’t easy. A hospital or healthcare center must consider the value of the service, administrative burden, and the safety and liability. Such considerations can make it hard to justify a transportation program.
QUALITY AND SAFETY
Any patient transportation program needs reliability and accountability. If a patient’s transportation service is an hour late, they’re going have a problem. They may have to wait for the doctor’s office to accommodate them, or they’ll have to reschedule their appointment altogether. That could cost them money, as well as time, not to mention delays getting care.
“There have been several occasions,” according to Ronetta, “where transportation is arranged for the patient and transport either shows up early and refuses to wait or they do not show up at all.”
Reliability is one thing, but safety is also an issue. “On one occasion, a patient was picked up for what should have been a twenty-minute ride that turned into two-hours. The driver got lost and took the patient on a ride to who-knows-where. The family was calling the unit looking for their loved one. The social worker had to call the company several times before speaking to someone. The patient made it home safely but this should not have happened. This patient required assistance and supervision for special needs.”
VALUE TO PATIENTS
A University of North Carolina Chapel Hill study examined transportation benefits provided to patients in a Medicare accountable care organization. “Participants were highly satisfied with the program, reporting that it eased financial burdens and made them feel safer, more empowered, and better able to take control of their health.”
A non-emergency transportation benefit managed for reliability and safety will provide true value to patients.
WHO GETS TRANSPORTATION HELP?
A patient’s insurance is often the deciding factor for transportation access. Medicaid makes non-emergency patient transportation available. Some private plans or Medicare Advantage plans may provide vouchers allowing patients to use services like Uber, Lyft or Curb.
Some cities have municipal patient transportation services, like New York City’s Access-a-ride. “If all else fails,” added Ronetta, “there is the local bus or train. It depends on the patient and their level of comfort at discharge.”
However, access to transportation is far from equitable. Patients who need regular healthcare services (dialysis as an example) need a reliable and affordable source of transportation. Owning or operating a vehicle is not possible for many patients, either due to health or cost. Living near a bus or train route is unlikely in rural areas.
Other than telehealth, there is no obvious answer for the challenges of transportation in healthcare. But when a patient leaves a medical facility after being inpatient, without a well-thought-out plan, patient transportation problems are likely. That vulnerable situation is not when patients should learn the transportation service they counted on isn’t going to show up. Unreliable transportation is inconvenient at best, and dangerous at worst.
Patients Rising has a diverse collection of resources on patient transportation for you to explore.
Ronetta is a case management associate for an inpatient behavioral health unit. She also has chronic daily migraine attacks with and without aura. Ronetta started advocating for migraines in 2019 and has since been awarded a proclamation in 2020 from the Mayor of Bristol, Connecticut for her tireless efforts during Chronic Migraine Awareness Month. She was also recently interviewed by Healthline where she discussed the diversity amongst women of color in the migraine community.
Ronetta is a member of Patients Rising’s Diversity, Equity and Inclusion Council.