Cancer patients often face significant challenges in accessing necessary medical care due to transportation insecurity. This article delves into the effects of this issue on cancer care, highlighting how Non-Emergency Medical Transportation (NEMT) services can offer vital support in reducing transportation barriers.

According to studies conducted by the Urban Institute, transportation insecurity affects as many as 1 in 4 adults in the United States, resulting in disruptions in medical care for many individuals. A recent survey revealed that 1 in 5 respondents without access to a vehicle or public transportation had to forgo essential medical care.

Cancer patients are particularly vulnerable to disruptions in care due to transportation insecurity. The nature of cancer treatment necessitates frequent healthcare visits over an extended period. Specialized care often requires patients to undertake additional travel burdens, and public transportation might be unsafe or logistically challenging for them. Moreover, the financial strain of cancer treatment can amplify transportation insecurity.

Quantifying the Impact of Transportation Insecurity

The extent of transportation insecurity among cancer patients varies, partly due to the absence of evidence-based screening guidelines. A survey of 25 National Comprehensive Cancer Network (NCCN) member institutions found that only 33% routinely screened patients for transportation insecurity.

To assess the impact of transportation insecurity on cancer patients, researchers analyzed data from the National Health Interview Survey. They compared 25,317 cancer survivors and 422,797 adults without cancer. After accounting for demographic factors and comorbidities, they discovered that transportation barriers were significantly more prevalent among cancer survivors (2.1%) compared to those without cancer (1.6%). Furthermore, cancer survivors facing transportation barriers experienced higher mortality rates.

Another study using the same survey data demonstrated that cancer survivors with transportation barriers were more likely to rely on emergency departments for routine care. They also faced higher risks of all-cause and cancer-specific mortality. Notably, these risks persisted even after accounting for insurance status.

The Role of Geography

Research has shown that individuals in rural areas are disproportionately affected by transportation insecurity. Limited healthcare provider density forces patients to travel longer distances for care, particularly impacting rural areas.

Addressing the Issue with Resources and Research

Further research is needed to fully understand the extent of transportation insecurity among cancer patients such as establishing screening guidelines and assessing the impact of policy changes on patient outcomes.

In the interim, resources are available to help patients overcome transportation-related barriers to care. Non-Emergency Medical Transportation (NEMT) services, a part of a prominent federal and state program, offers transportation assistance to eligible Medicaid beneficiaries for healthcare appointments. NEMT serves as a crucial solution to reducing transportation barriers, ensuring that cancer patients can access the necessary care without the hindrance of inadequate transportation options.

NEMT providers offer specialized transportation services tailored to the unique needs of patients, including those requiring medical support during transit. These providers ensure safe and reliable transportation to and from appointments and can help address cancer patients' challenges in accessing care.

By acknowledging the impact of transportation insecurity and utilizing programs like NEMT, the medical community can work towards ensuring that cancer patients receive the care they need, regardless of their transportation challenges.

This integrated approach helps alleviate one of the significant obstacles faced by cancer patients, enhancing their overall well-being and treatment journey.

References:

1. Murphy AK, McDonald-Lopez K, Pilkauskas N, Gould-Werth A. Transportation insecurity in the United States: A descriptive portrait. Socius. 2022;8. https://doi.org/10.1177/23780231221121060

2. Smith LB, Karpman M, Gonzalez D, Morriss S. More than one in five adults with limited public transit access forgo health care because of transportation barriers. Urban Institute. Published April 27, 2023. Accessed July 25, 2023.

3. Graboyes EM, Chaiyachati KH, Sisto Gall J, et al. Addressing transportation insecurity among patients with cancer. J Natl Cancer Inst. 2022;114(12):1593-1600. doi:10.1093/jnci/djac134

4. Chaiyachati KH, Krause D, Sugalski J, et al. A survey of the National Comprehensive Cancer Network on approaches toward addressing patients’ transportation insecurity. J Natl Compr Canc Netw. Published online January 2023. doi:10.6004/jnccn.2022.7073

5. Jiang C, Deng L, Wang Q, Perimbeti S, Han X. Transportation barriers to health care and mortality risk among the U.S. adults with history of cancer. J Clin Oncol. 2021;39:28_suppl, 121-121. doi:10.1200/JCO.2020.39.28_suppl.121

6. Jiang C, Deng L, Perimbeti S, et al. Associations of delays in care due to transportation barriers and care utilization, and cause-specific mortality risk among the US adults with a cancer history. J Clin Oncol. 2022;40:28_suppl, 70-70. doi:10.1200/JCO.2022.40.28_suppl.070 

7. NCCN convenes policy summit assessing impact of geography on cancer outcomes, examining rural and urban divide. News release. Published June 15, 2023. Accessed July 25, 2023.