Eliminating Transportation Barriers to Outpatient Therapy for Underserved Patients with Cancer

Abstract

Background: The cancer patients of Bellevue Hospital (BH) and Woodhull Hospital (WH) represent an underserved community, and are referred to New Y ork University Clinical Cancer Center (NYUCCC) for outpatient radiotherapy (RT). Commuting to NYUCCC poses a financial burden hindering treatment compliance. Purpose: To assess the impact of free metro-cards on the compliance rate of outpatient RT for BH/WH cancer patients with financial needs. Methods: Cancer patients at BH and WH were screened once referred for outpatient RT; met New Y ork State qualifications for Medicaid; did not live within 1 mile of NYUCCC; could use public transportation, did not have transportation assistance otherwise. Each patient received 1 free metro-card for the initial RT consultation and metro-cards for the entire course of planned RT. Results: From 12/01/2012 until 12/12/2013, 103 patients were enrolled, 102 patients completed RT sessions. The major ethnicities were Hispanic and Black, the average course of RT was 28.8 sessions, 90/102 patients (88%) compliance rate was achieved. 12/102 patients (12%) had at least 1 treatment delay or missed RT sessions solely attributed to urgent medical visits. Conclusion: Eliminating the financial burden of transportation costs leads to a high compliance rate of 88% with outpatient RT for underserved cancer patients, much higher than that of historical compliance rate of 50% in BH. Future studies in a larger underserved cancer patient population may help define the role of financial assistance during outpatient RT in patient compliance. Funding: Philanthropy funding from Capital One Bank through NYU Cancer Institute’s Development Office, Project ID # 51- D1500-72340, funding to support patient navigators who contributed to this study from NYU Cancer Institute and from the Avon Safety Net Grant # 05-2016-074.