交通干预措施对医疗保健结果的影响：系统评价。

Impact of Transportation Interventions on Health Care Outcomes: A Systematic Review.

机构信息

Neuroscience and Behavior Program, Wesleyan University, Middletown, CT.

Social Interventions Research & Evaluation Network, University of California, San Francisco, San Francisco, CA.

出版信息

Med Care. 2020 Apr;58(4):384-391. doi: 10.1097/MLR.0000000000001292.

DOI:10.1097/MLR.0000000000001292

PMID:31985588

Abstract

INTRODUCTION

Lack of reliable transportation can be a barrier to keeping appointments or accessing other health care services. Increasingly, insurers and health care delivery systems subsidize transportation services for patients. This systematic review synthesizes existing research on nonemergency medical transportation interventions.

METHODS

We searched 3 databases (Embase, PubMed, Google) for studies of health care sector-sponsored programs that provided patients assistance with nonemergency transportation and directly assessed the impact of transportation assistance on health and health care utilization outcomes. Studies meeting inclusion criteria were graded for quality using standard grading criteria.

FINDINGS

Eight studies met all inclusion criteria. Most were rated as low quality. All studies included examined process or health care utilization outcomes, such as uptake of transportation services, return for follow-up, or missed appointment rates; only 1 included health outcomes, such as illness severity and blood pressure. Results were mixed. More rigorous studies showed low patient uptake of transportation services and inconsistent impacts on health and utilization outcomes.

CONCLUSIONS

Despite considerable interest in subsidizing transportation services to improve health for patients facing transportation barriers, little rigorously conducted research has demonstrated the impact of transportation services on health or health care utilization. Some extant literature suggests that transportation assistance is more likely to be effective when offered with other interventions to reduce social and economic barriers to health.

摘要

简介

缺乏可靠的交通可能成为患者按时就诊或获得其他医疗服务的障碍。越来越多的保险公司和医疗服务提供系统为患者的交通服务提供补贴。本系统评价综合了现有关于非紧急医疗交通干预措施的研究。

方法

我们在 3 个数据库（Embase、PubMed、Google）中搜索了卫生保健部门赞助的项目研究，这些项目为患者提供非紧急交通援助，并直接评估交通援助对健康和医疗利用结果的影响。符合纳入标准的研究使用标准评分标准进行质量分级。

结果

8 项研究均符合所有纳入标准。大多数研究被评为低质量。所有纳入的研究都检查了交通服务使用的过程或医疗利用结果，如交通服务的利用率、后续就诊的返回率或预约错过率；只有 1 项研究包括健康结果，如疾病严重程度和血压。结果不一。更严格的研究表明，患者对交通服务的接受程度较低，对健康和利用结果的影响不一致。