Appointments and Schedules, Primary Health Care, Social Determinants of Health, Transportation
Conditions
Keywords
Rideshare, Digital transportation network, Missed appointment
Brief summary
This study is a prospective clinical trial designed to primarily test the impact of rideshare-based transportation services from a digital transportation network, Lyft, on reducing primary care clinic missed appointments--a composite outcome of no-shows and same day cancellations--for Medicaid patients. The study population consists of West Philadelphia residents who are established patients at two of the Penn Medicine Primary Care Practices within the University of Pennsylvania Health System. The study subjects are allocated into the intervention or control arm using a pseudorandomization approach - those receiving an appointment reminder on an even calendar day are in the intervention arm and odd calendar day calls are in the control arm. Secondary outcomes include the time of arrival to the clinics relative to actual appointment time (both arms), prospective utilization of acute care settings (both arms), prospective utilization of primary care (both arms), and description of programmatic metrics in the intervention arm (travel time, misuse, and costs). The investigators will assess the patient experience after each ride using a telephone-based survey and in-depth interviews. All adults with established primary care at the Penn Medicine Clinics, who have Medicaid, and do not require wheelchair accessible rides will be eligible for the rideshare service. The investigators hypothesize that individuals offered a rideshare-based transportation service will have a decreased proportion of missed appointments and same day cancellations as those not offered the service.
Interventions
OTHERRideshare-based transportation
Sponsors
Lyft, Inc.
University of Pennsylvania
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Patients insured by Medicaid * Established primary care patient at the Penn Medicine Clinics * Address in West Philadelphia zip code
Exclusion criteria
* Requiring wheelchair accessible transportation. We are unable to guarantee vehicles that will be able to accommodate these patients' physical needs.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The proportion of missed appointments (no-shows and same-day cancellation) in the intervention arm and the control arm | Within 2 days of enrollment | The missed appointment proportion is based on the one appointment for which patients were contacted to receive a free ride |
Secondary
| Measure | Time frame |
|---|---|
| Arrival time to clinic relative to the scheduled time (both arms) | Within 2 days of enrollment |
| Post-intervention, utilization frequency of acute care settings (both arms) | 7-days, 30-days, and 6 months post-appointment |
| Post-intervention, utilization frequency of primary care (both arms) | 7-days, 30-days, and 6 months post-appointment |
| Post-intervention, frequency of missed primary care appointments (both arms) | 30-days and 6-months post-appointment |
Countries
United States
Outcome results
None listed