The National Academies

TCRP B-27 [Completed]

Cost Benefit Analysis of Providing Non-Emergency Medical Transportation

  Project Data
Funds: $245,000
Research Agency: Altarum Institute
Principal Investigator: Paul Hughes-Cromwick
Effective Date: 2/20/2004
Completion Date: 8/19/2005

Prevention of disease and effective disease management are widely recognized as the best methods for reducing the cost of health care. About 13.5% of the U.S. gross domestic product goes toward health care, and a large portion of that amount is spent on hospitalization and intensive care. Regular visits to health care providers by persons suffering from chronic disease such as diabetes, asthma, and hypertension significantly reduce long-term health care costs by reducing the likelihood that patients will be hospitalized later with severe complications stemming from their diseases. Additional savings can be achieved by (1) the early diagnosis of cancer through regular screening, (2) comprehensive vaccination programs, and (3) a regular schedule of prenatal visits for pregnant women.

One of the largest barriers to increasing prevention of disease and improving disease management is a patient's limited access to medical services. Although there are many ways to improve access to medical services (e.g., by building additional medical facilities or increasing the number of multilingual health care providers), improving transportation services to physicians' offices and clinics may be one of the most beneficial.

Many elderly, low-income, and minority individuals who need medical care to manage chronic disease or to receive medical screenings and vaccinations are transportation disadvantaged. They do not have adequate or appropriate transportation services to travel to medical appointments. Some medically under-served people do not have access to automobiles or transit services and require different types of transportation services, such as ambulatory, wheelchair, or stretcher transportation services. Providing improved transportation services to medically under-served individuals so that they can access needed health care programs may produce significant net savings to the health care system.

The objective of this study is to assess the relationship between increased investments in transportation services for medical trips for people who are medically under-served and transportation disadvantaged and overall reductions in health care costs. This study addresses transportation services to scheduled medical appointments and does not include transportation for medical emergencies.

Status: The project has been completed.

Product Availability: The executive summary is published as TCRP Research Results Digest 75. The entire report and appendixes are published as TCRP Web-Only Document 29. A spreadsheet tool that enables local transportation and social service agencies to tailor cost benefit analyses of NEMT to their own local demographic and socio-economic environments is available by clicking on the link.

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