Clinical trial NCT02955433: The Impact of Rideshare Transportation Services on Appointment Adherence
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Appointments and Schedules
Social Determinants of Health
Transportation
Primary Health Care
Keywords: Rideshare
Digital transportation network
Missed appointment
Lead sponsor: University of Pennsylvania
Sponsor class: OTHER
Collaborators: name: Lyft, Inc.
First posted: 2016-11-04
Enrollment: 786
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

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.


Eligibility criteria: 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.

Primary outcomes:
measure: The proportion of missed appointments (no-shows and same-day cancellation) in the intervention arm and the control arm
timeFrame: Within 2 days of enrollment
Secondary outcomes:
measure: Arrival time to clinic relative to the scheduled time (both arms)
timeFrame: Within 2 days of enrollment
measure: Post-intervention, utilization frequency of acute care settings (both arms)
timeFrame: 7-days, 30-days, and 6 months post-appointment
measure: Post-intervention, utilization frequency of primary care (both arms)
timeFrame: 7-days, 30-days, and 6 months post-appointment
measure: Post-intervention, frequency of missed primary care appointments (both arms)
timeFrame: 30-days and 6-months post-appointment
Other outcomes:
Locations:
city: Philadelphia
country: United States
facility: Penn Internal Medicine Primary Care Practice
state: Pennsylvania
Study officials:
References:
citation: 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.
citation: 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.