Transportation Assistance in Gynecologic Oncology
DESCRIPTION
Cancer care often requires frequent travel to and from appointments, hospitals, and treatments. Many patients, however, do not have consistent access to reliable and affordable transportation methods. This is especially true for gynecologic oncology patients—one third of whom experience transportation barriers to care. Because of their limited access to transportation, these patients are more likely to have delays in their cancer care, and they are less likely to receive ideal treatment.
To reduce the impact of transportation barriers, this pilot study implemented a transportation intervention for patients with gynecologic cancer across five University of Pennsylvania gynecologic oncology practices. Led by PC3I Faculty Anna Jo Smith, MD, MPH, MSc, researchers used patient portals to screen patients for social determinants of health and identify those with transportation needs. Patients who screened positive were then referred to a ride-sharing service called RideHealth. Rides to and from clinic visits, chemotherapy, radiation sessions, or surgical procedures were scheduled by the clinical team, and patients received updates from their driver via text messages in their preferred language.
In this study, there were no income or insurance restrictions for the ride-sharing service, but patients had to live within twenty-five miles of their oncology practice. In the first year of the program, more than 420 rides were provided, serving 50 patients. Patients who received transportation assistance were more likely to be older, self-identify as a race other than white, have Medicare or Medicaid insurance, and have a higher ECOG score, which determines a patient’s ability to tolerate serious illness therapies, than the overall patient population.
IMPACT
Pilot findings indicate that ride-sharing services with easy scheduling can expand access to transportation. Transportation assistance facilitates access to gynecologic care and may facilitate more equitable cancer care delivery. Further evaluation of the clinical impact of transportation assistance is ongoing as PC3I Faculty Emily Ko, MD, MSCR leads a follow-up grant, funded by the Ovarian Cancer Research Alliance (OCRA), to analyze the clinical and cost-effectiveness of transportation assistance and other supportive care programs in Gynecologic Oncology spaces.
PEOPLE
Anna Jo Smith, MD, MPH, MSC; Justin E. Bekelman, MD; Meredith Doherty, PhD, LCSW; Stefanie N. Hinkle, PhD; Emily M. Ko, MD, MSCR; Nathanael C. Koelper, MPH; Mary Pat Lynch, DNP, CRNP; Kristina Powell, BA; Fiona Simpkins, MD; Megan Wachlin, BSN, OCN
FUNDING
Ovarian Cancer Research Alliance (OCRA)
PARTNERS
Susan (Simcha) Rudolph Ovarian Cancer Patient Assistance Program
FOCUS
Health Equity
PUBLICATIONS
Transportation assistance in gynecologic oncology: A pilot study. JCO Oncology Practice.