Rideshare services for transportation assistance in gynecologic oncology: a quality improvement study
Transportation barriers can lead to delays in care and suboptimal treatment. Our objective was to assess the utilization of a novel transportation pilot intervention in gynecologic oncology. Since May 2022, we have provided donor-funded transportation to patients receiving gynecologic cancer treatment at 5 University of Pennsylvania practices. Patients are screened for transportation barriers at first visit and re-screened during care. Patients who screen positive are referred to the intervention, a HIPAA-compliant ride-sharing service. There are no income or insurance restrictions; distance was limited to 25 miles. We report descriptive statistics on ride completion, distance traveled, and cost. In the 15-month pilot, 133 of 4,376 patients (3%) screened positive, and 48 (1%) patients received rides. Of 85 patients who screened positive, but did not receive ride-sharing, 43 (51%) had transportation assistance through their insurance, 12 (14%) lived more than 25 miles away, and the remainder (30; 35%) identified alternative transportation. 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 than the overall patient population. Eight patients received a single ride, and the rest (n = 40) received multiple rides (range 2-30) for total of 417 rides. The mean time via ride-sharing was 19.5 min shorter than public transportation, and mean cost of a one-way trip was $25.75 (range $13.83-129.91). A rideshare service served a socially-vulnerable population and reduced commute times to oncology visits, which may contribute to more equitable access to cancer care. Further research on clinical outcomes is needed to understand the impact of transportation assistance on equitable cancer care delivery.