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Missed or delayed medical care appointments by older users of NEMT services

机译：NEMT服务的旧用户错过或延迟预约医疗服务

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Non-emergency medical transportation (NEMT) can prevent emergency care as a result ofdelayed or missed medical appointments. Medicaid provides NEMT for low income individualswho have no other means of transportation and this is a critical component of the health caredelivery system. This study examined cancelled trips in Medicaid adults age 65+ to explorewhether barriers persist for a growing segment of the population who face particular challengesof age-related declines in health and function. Multivariate logistic regression analyses wereconducted using transportation brokerage data for Delaware members who intended to travelduring 2008-2010, modeling the odds of all cancellations and then these mutually exclusivetypes: (1) client cancelled; (2) client obtained alternative transportation; and (3) client cancelleddue to health. Over half of the cancelled trips were attributed to client reasons. Black race wasassociated with client canceling (OR=1.4) and canceling due to alternative transportation(OR=1.9). Compared to dialysis, trips for other medical care were more likely to be cancelled forclient and health reasons (ORs ranged 1.6-7.9). Higher levels of service increased cancelling forhealth reasons (OR=2.9 stretcher; OR=1.8 wheelchair). Finally, pre-scheduled or subscriptiontrips were less likely to be cancelled and client factors differed for the cancellation of trips thatwere not regularly scheduled. The results of this initial study confirm that for this populationadditional transportation services are often not available and that more support for utilizingNEMT may be needed. Future research should evaluate persistent barriers, service delivery, andlong-term outcomes.
机译：非紧急医疗运输（NEMT）可能会由于以下原因而导致无法进行紧急护理 延迟或错过医疗预约。 Medicaid为低收入人士提供NEMT 没有其他交通工具的人，这是医疗保健的重要组成部分 输送系统。这项研究调查了65岁以上的医疗补助成年人的已取消旅行，以探索 面临特殊挑战的人口增长壁垒是否持续存在 与年龄有关的健康和功能下降。多元逻辑回归分析为 使用打算旅行的特拉华州成员的运输经纪数据进行的 在2008-2010年期间，对所有取消的赔率进行建​​模，然后对这些互相排斥的赔率进行建​​模 类型：（1）客户已取消; （2）客户获得替代运输;和（3）客户已取消 由于健康。超过一半的取消旅行归因于客户原因。黑人种族原为 与客户取消（OR = 1.4）和由于替代运输而取消相关 （或= 1.9）。与透析相比，其他医疗旅行更可能被取消 客户和健康原因（OR范围为1.6-7.9）。较高的服务水平取消了 健康原因（OR = 2.9担架; OR = 1.8轮椅）。最后，预先安排或订阅 行程被取消的可能性较小，并且因以下原因而取消行程的客户因素也有所不同 没有定期安排。这项初步研究的结果证实，对于该人群 附加的运输服务通常不可用，并且更多的利用支持 可能需要NEMT。未来的研究应评估持续存在的障碍，服务提供以及 长期结果。

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