Study: Planning, Caregiver Support Decrease Dr. Visit No-Shows

It’s a common misconception that home health care ends at the client’s front door.  In fact, some of the most important work performed by home caregivers involves linking clients with medical care and services they need in order to remain healthy and independent.

A recent study published by the Gerontological Society of America that looks into transportation and medical appointment cancellations seems to lend further credence to the belief that a strong caregiver support network can decrease medical appointment no-shows and improve the overall health of an older adult.

The Study

Because medical care provided by a physician or other medical specialist outside the home can play a major role in the long-term health and well-being of a person aging in place, this study set out to identify what factors make an individual more likely to cancel transportation, thus missing their appointment.

This study used data from a large, Medicaid-funded, non-emergency medical transportation (NEMT) service in Delaware (similar to New York’s Access-A-Ride service), covering three calendar years (2008-2010) of scheduled trips to and from a client’s home to their medical provider’s office.  In total, more than 125,000 scheduled NEMT trips were reviewed for the study.

The Results

After reviewing the available data, researchers came away with some interesting observations that give us a better insight into how and why patients might miss medical appointments.  Overall, the study found that 6 percent of all scheduled NEMT trips did not occur, either due to client or provider-related reasons.

1 – The study found that, trips scheduled for same-day service were more than twice as likely to be cancelled (13 percent) when compared to regularly scheduled trips or trips scheduled between 2 and 30 days prior to service.

2 – The study found that non-ambulatory patients (those dependent on wheelchairs or stretchers) were much more likely to cancel scheduled NEMT trips to their care provider than those who were able to walk under their own power.  Researchers suspect limited mobility makes it harder for patients to reach their pick-up location on time, or the patient’s health status might have declined to the point where emergency medical transportation was required.

3 – Researchers also found that age had very little impact on NEMT trip cancellations, meaning that those aged 85 and higher were just as likely to cancel trips as those 20 years their junior.  Researchers suggested this might stem from older adults being more likely to have some type of in-home care provider to assist in trip planning, scheduling and transport.

How Home Care Can Help

From a home health care provider’s point of view, this study suggests that a well-organized support system headed by an in-home caregiver can play an important role in linking a patient to the rest of their medical support network.

Home caregivers can schedule NEMT transportation well in advance of the day they are needed and help their patient  remember these important dates by maintaining a schedule in the home.  This added level of planning and oversight ensures patients avoid last-minute scheduling and a heightened chance of missing their appointments.

The study also suggests that those with limited mobility are much less likely to miss medical appointments if assisted by a home caregiver trained to provide escort assistance, reducing the chances of falls and allotting a proper amount of time to make the scheduled pick-up time.

Finally, it should be noted that New York City offers a special yellow cab service specifically for individuals with limited mobility.  To use this service, simply call the TLC dispatcher at (646) 599-9999 and request a wheelchair accessible taxi. Check the following link for further details on this great service.

At SelectCare, we understand that our team of home health caregivers, service coordinators and nurse supervisors play a vital role in connecting our clients to the rest of their medical teams, loved ones and communities.

To learn more about SelectCare and how we can help you, a loved one, or a patient continue to live happy, healthy lives in the comfort of their longtime home, call us today.