Measuring the Impact of Transportation on Health Outcomes

We know anecdotally that a lack of appropriate transportation to support access to health care can often be a barrier to improved patient outcomes. What we don’t know is the extent to which this is true. There is no systematic collection of data on the reasons why individual patients do not make it to primary care and specialist appointments, nor are data regularly gathered from patients being discharged after hospitalization on what barriers might prevent them from making follow-up appointments that will help keep them from being re-hospitalized.

There are initiatives to incorporate data on transportation, housing, and other social determinant of health information into electronic health records. In addition, efforts are underway to determine how to incorporate social determinants, which have a large impact on physical and mental health, into diagnostic coding systems. These systems include the Current Procedural Terminology (CPT), which lists codes used to report health care services to health insurance companies for reimbursement. Another system is the International Classification of Diseases (ICD-11), the international diagnostic classification standard for all clinical and research purposes. By identifying the need for housing or transportation into a patient’s clinical record, and seeking reimbursement for interventions that address those needs, the health care system can not only begin to address these important determinants of health, but also begin to collect data on their impact in a systematic way.