The role of emerging mobility solutions in shaping care-seeking behaviors in rural communities: A national survey with stated choice experiment

Abstract

Transportation barriers significantly hinder access to medical appointments, particularly for minorities, patients with chronic conditions, and the economically disadvantaged. This study examines the relationship between ride-hailing transportation attributes and the likelihood of attending routine doctor appointments, using data from a national survey with a stated choice experiment. Mixed logistic regressions were applied to analyze correlations between sociodemographic profiles, transportation service attributes, and appointment adherence, with a focus on urban-rural differences. The findings show that flexible routes are crucial for rural patients, who often combine multiple activities in a single trip, making direct returns home impractical. Analysis of two subgroups, those who have delayed treatment and those who have not, revealed nuanced patterns. Patients who delayed treatment face greater time constraints due to being younger, employed, and lacking vehicles or comprehensive insurance. For this group, shorter booking times, flexible routes, and minimized ridesharing significantly increase the likelihood of attending appointments. In contrast, patients who have not delayed treatment are less influenced by transportation attributes, reflecting their higher vehicle ownership, shorter travel times, and greater likelihood of being retirees. These results emphasize the need for tailored, group- and region-specific strategies. This study emphasizes the importance of reevaluating cost-minimization policies in non-emergency transportation Medicaid and Medicare services to better meet patient needs. It advances the literature by quantifying how ride-hailing attributes influence appointment adherence, offering insights for reducing no-show rates and improving health outcomes.