2013 Session: 369

• Missed or Delayed Medical Care Appointments by Older Users of Nonemergency Medical Transportation Services
  Abstract: Non-emergency medical transportation (NEMT) can prevent emergency care as a result of delayed or missed medical appointments. Medicaid provides NEMT for low income individuals who have no other means of transportation and this is a critical component of the health care delivery system. This study examined cancelled trips in Medicaid adults age 65+ to explore whether barriers persist for a growing segment of the population who face particular challenges of age-related declines in health and function. Multivariate logistic regression analyses were conducted using transportation brokerage data for Delaware members who intended to travel during 2008-2010, modeling the odds of all cancellations and then these mutually exclusive types: (1) client cancelled; (2) client obtained alternative transportation; and (3) client cancelled due to health. Over half of the cancelled trips were attributed to client reasons. Black race was associated with client canceling (OR=1.4) and canceling due to alternative transportation (OR=1.9). Compared to dialysis, trips for other medical care were more likely to be cancelled for client and health reasons (ORs ranged 1.6-7.9). Higher levels of service increased cancelling for health reasons (OR=2.9 stretcher; OR=1.8 wheelchair). Finally, pre-scheduled or subscription trips were less likely to be cancelled and client factors differed for the cancellation of trips that were not regularly scheduled. The results of this initial study confirm that for this population additional transportation services are often not available and that more support for utilizing NEMT may be needed. Future research should evaluate persistent barriers, service delivery, and long-term outcomes.
  Authors: MacLeod, Kara E.; Ragland, David R.; Prohaska, Thomas R.; Irmiter, Cheryl; Satariano, William; Leary, Mary A.
  Authors: MacLeod, Kara E.; Ragland, David R.; Prohaska, Thomas R.; Irmiter, Cheryl; Satariano, William; Leary, Mary A.
  Year: 2013
  Document Type: Paper
  Subject: Passenger Transportation; Public Transportation
  Session: 369
  Paper Number: 13-2879
• Transportation in an Aging Society: Linkage Between Transportation and Quality of Life
  Abstract: This paper explored the effect of transportation factors on older peoples’ (65 years and older) quality of life. The data is drawn from a national telephone survey done by the American Association of Retired Persons (AARP). Exploratory Factor Analysis is used to develop a quality of life index based on five survey questions. Linear regression is used to explore the quality of life index’s correlation to transportation as well as various personal, household, and community characteristics.The results show that those with low socio-economic status and a limited social network are linked with lower quality of life. Also, various transportation factors are found to be significant. Lack of transportation in general and especially not driving, are found to be significant factors negatively associated with quality of life. A built environment, which facilities walking, is found to be positively associated. This study found that accessibility to alternative transportation is found to be positively associated with older people’s quality of life. Specifically, information about transportation options and transportation alternatives for those with disabilities and health problems are found to be significant for older people’s quality of life. This indicates that development of transportation alternatives, along with improved accessibility and visibility, is critical for older people’s quality of life in an aging society.
  Authors: Kim, Sungyop; Ulfarsson, Gudmundur Freyr
  Authors: Kim, Sungyop; Ulfarsson, Gudmundur Freyr
  Year: 2013
  Document Type: Paper
  Subject: Passenger Transportation; Public Transportation
  Session: 369
  Paper Number: 13-3619
• The Adoption of Complete Streets Policies in Transportation-Disadvantaged Communities: Lessons from U.S. Case Studies
  Abstract: In the last ten years, Complete Streets has become a growing policy movement. An increasing number of jurisdictions have passed Complete Streets policies that formalize that community’s intent to plan for, engineer, construct and maintain transportation facilities that serve, automobiles, transit, bicycles, pedestrians and freight. The multimodal infrastructure these policies encourage has the potential to improve the quality of life for groups traditionally underserved by automobile oriented development, also called the transportation disadvantaged. However, very few of these policies directly acknowledge the importance of serving the transportation disadvantaged. This study profiles three communities that have prioritized walking, biking and transit investments that serve these populations: the Sault Ste. Marie Tribe of Chippewa Indians, Michigan; the City of Portland, Oregon; and the City of Decatur, GA. The paper addresses shared lessons for other communities looking to effectively include diverse communities in the planning process and create explicit project criteria and plans that address the equitable distribution of transportation infrastructure.
  Authors: Clifton, Kelly J.; Bronstein, Sarah; Morrissey, Sara
  Authors: Clifton, Kelly J.; Bronstein, Sarah; Morrissey, Sara
  Year: 2013
  Document Type: Paper
  Subject: Passenger Transportation; Public Transportation
  Session: 369
  Paper Number: 13-4615
• Missed or Delayed Medical Care Appointments by Older Users of Nonemergency Medical Transportation Services
  Authors: MacLeod, Kara
  Authors: MacLeod, Kara
  Year: 2013
  Document Type: Presentation
  Subject: Passenger Transportation; Public Transportation
  Session: 369
  Paper Number: 13-2879
• The Adoption of Complete Streets Policies in Transportation-Disadvantaged Communities: Lessons from U.S. Case Studies
  Authors: Clifton, Kelly
  Authors: Clifton, Kelly
  Year: 2013
  Document Type: Presentation
  Subject: Passenger Transportation; Public Transportation
  Session: 369
  Paper Number: 13-4615
• The Adoption of Complete Streets Policies in Transportation-Disadvantaged Communities: Lessons from U.S. Case Studies
  Authors: Bronstein, Sarah
  Authors: Bronstein, Sarah
  Year: 2013
  Document Type: Presentation
  Subject: Passenger Transportation; Public Transportation
  Session: 369
  Paper Number: 13-4615
• Transportation in an Aging Society: Linkage Between Transportation and Quality of Life
  Authors: Kim, Sungyop
  Authors: Kim, Sungyop
  Year: 2013
  Document Type: Presentation
  Subject: Passenger Transportation; Public Transportation
  Session: 369
  Paper Number: 13-3619
• Transportation in an Aging Society: Linkage Between Transportation and Quality of Life
  Authors: Ulfarsson, Gudmundur
  Authors: Ulfarsson, Gudmundur
  Year: 2013
  Document Type: Presentation
  Subject: Passenger Transportation; Public Transportation
  Session: 369
  Paper Number: 13-3619