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Hospital-Provided Rideshare at UH Seidman Cancer Center Boosts Radiation Therapy Completion Rates for Vulnerable Patients, Study Shows

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UH Clinical Update | January 2023

Rideshare services provided by UH Seidman Cancer Center to help patients get to their appointments, funded by donations to the cancer center, are having a significant impact in the community for a relatively small financial cost, according to a new UH study.

Data presented recently at UH Research and Innovation Day shows that patients who use hospital-provided rideshare services to get to their radiation therapy appointments are significantly more likely than other patients to complete their course of prescribed radiation therapy, improving their chances of a good outcome. Of the rideshare-facilitated treatments, 100 percent were completed, with an overall course completion rate of 97.3 percent, compared to 85.4 percent for those who did not use rideshare.

Importantly, geospatial analysis of census data included in the study shows that UH Seidman patients using rideshare to get to their radiation therapy appointments come disproportionately from Northeast Ohio communities with significantly higher rates of resource deprivation, suggesting the service is assisting those who truly need it.

These benefits also come with a relatively modest price tag. Rideshare services are provided by the hospital at no cost to patients facing transportation barriers who qualify after assessment by social work. Even among patients who used rideshare for at least 45 percent of their appointments, the average revenue potentially facilitated per treatment course was $12,923, with the average rideshare cost per treatment course just $362. The median cost of each rideshare was just $13.04, which suggests the revenue potentially facilitated by rideshare services is magnitudes greater than rideshare cost.

An Under-studied Topic

Along with a multidisciplinary team, Eric Chen, MD, a radiation oncology resident at UH Seidman Cancer Center, led this project, which was named best research abstract at Research and Innovation Day. He says it’s among the first studies to document the effect that rideshare services can have to facilitate timely radiation therapy, especially for resource-limited patients. Other research, he says, has shown that the distance a patient needs to travel to a treatment center affects both the duration of treatment and the decision to receive radiation therapy in the first place.

Eric Chen, MD UH ResidentEric Chen, MD

“It is evident that travel distances, and the burden of transportation as a whole, can adversely impact treatment decisions and outcomes for cancer patients undergoing radiation therapy,” he says. “With our study, we wanted to evaluate the impact of rideshare services provided by our cancer center to help address this barrier.”

Who is Eligible for Rideshare?

The new study included 63 patients who used hospital-provided rideshare service for at least one radiation therapy appointment at UH Seidman Cancer Center in 2017-18 or 2021-22. Patients were eligible for rideshare services if they did not have family or friends available to assist with transportation, did not qualify for transportation arranged through their insurance carrier or charitable organizations, did not have access to public transportation for which they could receive free vouchers, could not reside in nearby free patient lodging made available to them by the hospital, or could not utilize subsidies for gas money for those who had a vehicle.

“This is really the last resort for patients after social work screens them for any other possible means of getting to their radiation treatments,” Dr. Chen says. “It’s crucial.”

Clear Benefits

Dr. Chen and his colleagues are next working to gather more data to better understand why the UH Seidman Cancer Center patients who used rideshare were lacking other transportation options. But he says even these preliminary study results show that the benefits of providing the service are clear – for patients, communities and health systems.

“A prior study found that 92 percent of patients who utilized rideshare services would not have been able to attend their radiation therapy treatment appointments without rideshare services, indicating that no show appointments were circumvented,” he says. “Since treatment package time has been shown to improve oncologic outcomes in several disease sites, hospital-provided rideshare services may therefore reduce treatment delays and improve tumor control.”

“Other benefits of rideshare services that may be difficult to measure but are nonetheless just as important include the effect on mental health, improvement in social support, and mitigation of lost wages by caregivers who would have otherwise had to provide the transportation,” he adds. “Rideshare services provided by the hospital at no cost to the patient can also help patients from vulnerable communities receive quality radiation services. While many systemic and structural barriers contribute to inequitable healthcare access, hospital-provided rideshare services can eliminate transportation barriers and reduce the burden of cancer-associated costs at the individual level, thus ameliorating some of the health disparities facing our most vulnerable patients.”

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