We don’t commonly think of public transportation as part of health care policy, though the people who work in public health know it’s important. But maybe we should, according to a new study focused on the opening of a light-rail line in the Twin Cities.
A group of researchers from the Urban Institute, Harvard Medical School, Mass General, and the University of Minnesota studied what happened to no-show outpatient appointments at a major health system when the Green Line opened in the Minneapolis-St. Paul area in 2014, connecting those two cities’ downtowns. The new Metro line was more reliable — less susceptible to traffic jams or bad weather — and ran more frequently than the buses that had previously covered the same route.
By looking at data from before the rail line’s opening and differentiating between patients who lived near the new transportation service versus those who did not in order to establish a baseline, the authors were able to isolate the effect of the Metro line. The impact they found was significant, much more than previous studies that had attempted to measure the effects of transportation on patients’ behavior.
They found a meaningful reduction in the number of no-show appointments among patients who lived near the Green Line, with the no-show rate dropping by 4.5 percent compared to the baseline. The effect was particularly profound for Medicaid patients, who saw their no-show rate decline by 9.5 percent compared to the baseline.
The researchers also found an increase in same-day appointments for patients and clinics located near the new rail line, indicating the expanded transportation options also made it easier for people to get urgent or otherwise unplanned medical care.
Why does this improvement in attendance matter? Patients get more reliable care, which can help head off bigger health problems down the road, and providers don’t end up with a bunch of empty slots that could have been filled by other patients.