The Impact of Rideshare Transportation Services on Appointment Adherence

NCT02955433 | Completed

• 1 other identifier: IRB-824715
• Study Type: interventional
• Target: 786
• Locations: 1 country
• Sites: 1

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.

Conditions

Appointments and Schedules; Social Determinants of Health; Transportation; Primary Health Care

Keywords

Rideshare; Digital transportation network; Missed appointment

Outcome Measures

Primary Outcomes (1)

• The proportion of missed appointments (no-shows and same-day cancellation) in the intervention arm and the control arm

  The missed appointment proportion is based on the one appointment for which patients were contacted to receive a free ride

  Within 2 days of enrollment

Secondary Outcomes (4)

• 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

Study Arms (2)

Rideshare

EXPERIMENTAL

The intervention arm will receive an appointment reminder and free transportation for one appointment to travel between the patient's home and primary care clinic using a rideshare-based transportation service.

Other: Rideshare-based transportation

Control

NO INTERVENTION

The control arm will receive an appointment reminder, but no free transportation offer.

Interventions

Rideshare-based transportation OTHER

Also known as: Digital transportation network, Lyft

Rideshare

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients insured by Medicaid
• Established primary care patient at the Penn Medicine Clinics
• Address in West Philadelphia zip code

You may not qualify if:

• Requiring wheelchair accessible transportation. We are unable to guarantee vehicles that will be able to accommodate these patients' physical needs.

Sponsors & Collaborators

• University of Pennsylvania: lead
• Lyft, Inc.: collaborator

Study Sites (1)

Penn Internal Medicine Primary Care Practice

Philadelphia, Pennsylvania, 19146, United States

Location

Related Publications (2)

• Chaiyachati KH, Hubbard RA, Yeager A, Mugo B, Lopez S, Asch E, Shi C, Shea JA, Rosin R, Grande D. Association of Rideshare-Based Transportation Services and Missed Primary Care Appointments: A Clinical Trial. JAMA Intern Med. 2018 Mar 1;178(3):383-389. doi: 10.1001/jamainternmed.2017.8336.

  PMID: 29404572 RESULT

• Chaiyachati KH, Hubbard RA, Yeager A, Mugo B, Shea JA, Rosin R, Grande D. Rideshare-Based Medical Transportation for Medicaid Patients and Primary Care Show Rates: A Difference-in-Difference Analysis of a Pilot Program. J Gen Intern Med. 2018 Jun;33(6):863-868. doi: 10.1007/s11606-018-4306-0. Epub 2018 Jan 29.

  PMID: 29380214 RESULT

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor of Medicine at the Perelman School of Medicine

Study Record Dates

• First Submitted: October 31, 2016
• First Posted: November 4, 2016
• Study Start: October 1, 2016
• Primary Completion: April 1, 2017
• Study Completion: November 1, 2017
• Last Updated: July 8, 2019

Record last verified: 2019-07

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)