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February 23, 2014 11:00 PM

Poor transportation could block gains in pediatric healthcare

Andis Robeznieks
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    Transportation barriers could block possible gains in children's healthcare created by expanding insurance coverage as part of healthcare reform, contend researchers with the New York-based Children's Health Fund.

    “While health reform can be predicted to improve access to child healthcare for millions of currently uninsured children, geospatial barriers will persist,” the researchers wrote in a letter posted on the JAMA Pediatrics website. “Only by resolving these barriers with new transportation resources will children reliably benefit from health reform.”

    The authors cite a 2013 study by the Children's Health Fund noting that 4% of children (about 3 million kids) miss a healthcare appointment each year because of transportation issues. For children in families making less than $50,000 a year, however, that figure climbs to 9%. And 31% of those children later visited a hospital emergency department for the condition associated with their missed appointment.

    The problem can be more acute in rural areas where public transportation options are few and where many counties have been identified as federal health professional shortage areas. The researchers identified that 55 of the state of Mississippi's 82 counties were at high risk for transportation barriers to healthcare access, and all but two were identified as health professional shortage areas, for example.

    Distances to clinics averaged roughly six to 14 miles depending on population density, but 13% of these counties had no public transportation and public transportation was described as “limited" for the remaining 87%.

    “The distances involved weren't enormous; most people were within six miles of a clinic,” according to a post on the Children's Health Fund blog. “But without a car, and with limited public transportation options, it was difficult for them to get themselves and their kids to the doctor regularly.”

    The study's authors conclude that additional planning is needed to address the development of new transportation services and they suggested that the cost of these services could be offset over time by savings from reduced emergency department visits.

    The Children's Health Fund Transportation Initiative receives support from the W.K. Kellogg and Kresge foundations.

    Follow Andis Robeznieks on Twitter: @MHARobeznieks

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