“Peer Review” Focuses and Questions

Apart from the difficulty faced by the patients in the United States in receiving proper healthcare transportation, the U.S. government is also facing challenges in constructing ambulance service. In 2011, the government has spent approximately $14 billion on ambulance services. This huge number places a great burden on the health care spending and budget for the entire country. In addition, it is reported by Frakt in 2018 that there are a considerable amount of fraudulent bills to request Medicare paying for the ambulance service, reaching about 30%.

From the above scenario, it can be seen that addressing ambulance service is a complex issue. It is not easy to address the delayed and unsatisfied high cost of transportation services to receive timely health care services because of the issue is complex. It requires the collaboration of multiple parties, such as hospitals, governments, insurance providers, patients, etc. It also imposes a great challenge on the traffic conditions in the United States. But it is necessary to address the concerns of the patients who need transportation to health care because no one can guarantee that they would not need to go to hospitals in their life and because sometimes it is really urgent in needing the transportation to health care.

The target audience for this research is government, hospitals and ride-hailing service providers (like Uber and Lyft). Three solutions, including setting up programs of visiting doctors, setting up mobile health centers, and/or integrating ride-hailing providers to partner up with health care providers in offering fast and cheap transportation to and from hospitals, are proposed here with an illustration of their benefits, obstacle and ways to mitigate the obstacles.

Solution 1 Visiting Doctors

Benefits

Setting up programs of visiting doctors will benefit patients most. In this program, doctors will go out of hospitals and visit the houses of patients to help them identify simple diseases and deliver drugs to them. In this program, patients do not even need to step out of their houses to receive medical care services. They do not need to travel back and forth to hospitals to seek health care services. This can be especially beneficial for those elderly or disabled people because of the more difficulty in traveling they face. Another benefit is the cost saving for patients. They do not need to call an ambulance that is surprisingly expensive. They do not need to take a taxi that can impose a financial burden on them. In addition, it is also time-saving for them. They do not need to spend time on traveling nor on queueing in the hospitals, waiting for the services, as analyzed by Flanagan et al in 2010.

Obstacles

Despite the apparent benefits the visiting doctors have, there are also several obstacles for this solution. First of all, this program imposes high demands for doctors. Apart from doctors working in the hospitals to service those traditional patients, extra groups of doctors are needed in this program for traveling in a county or district. It can be difficult, as revealed by Elliott et al in 2017, for many hospitals to set aside this obstacle considering that the number of health care workers in the United States is so limited.

Another major obstacle is the cost for hospitals or government. Government or hospitals will have to pay extra for the traveling costs of the doctors in this program. In addition, they also need to pay for hiring more doctors to join this program. It can be difficult to achieve this goal in the short term due to the lack of financial resources.

How to Mitigate the Obstacles

To mitigate the above obstacles, it is important for governments, hospitals, and communities to negotiate together on how to allocate financial resources to support the extra cost in this program. The fund may come from taxpayers, Medicare, or other specifically raised ones. Recruiting more college students in the major of pharmacy or related fields to solve the long-term shortage of doctors can be another strategy even though it takes much longer to achieve the goal.

Option 2 Mobile Health Centers

Benefits

Setting up mobile health centers benefit the residents in the entire communities where the centers are located because they can receive health care services within walking distance. This is time-saving and cost-saving for residents in the communities. At the same time, it can alleviate the traffic pressure in the United States, to reduce traffic jam with fewer transportation trips back and forth to hospitals. Mobile health centers will also help the government save money in investing in ambulance services. Another key benefit is that patients can save money by reducing the chances of using ambulance services. The mobile health centers can cover a larger area of service as compared to health centers in the communities due to its easy mobility.

Obstacles

However, the major obstacle is the cost. It requires the construction of health care service centers that can be expensive. Constructing mobile health care centers may be even more expensive than building a community health care center because extra considerations are needed for the mobility and the relevant facilities in the mobile centers. Another cost associated with mobile health centers is the payment for the doctors hired in the centers.

Another obstacle is the design issue. Since there are very few such mobile health centers, designing becomes a big challenge with comprehensive consideration and wide coverage for disease treatments. Furthermore, the weight and mobility are also key factors to be considered at the same time. As such, it becomes a complex issue in implanting this solution

How to Mitigate the Obstacles

To mitigate the above obstacles, it is important for governments, hospitals, and communities to negotiate and plan carefully on how the financial resources can be allocated. Local tax payment may be one option. The donation is also possible from enterprises that are interested in investing it. Furthermore, to address the obstacle of design, it is important for hospitals to collaborate with automobile companies and medical equipment companies to come up with a solution that can accommodate all demands for the mobile health centers.

Option 3 Collaboration with Ride-Hailing Services (like Uber/Lyft).

Benefits

Collaboration with ride-haling services as a complementary for ambulance transport has several benefits. First of all, it is much cheaper than ambulance services. Based on the charge standards of Uber and Lyft, it is difficult to cost patients even one thousand while ambulance services can easily reach this number. In addition, the response time of ride-hailing services would be much shorter as compared to the ambulance, according to the article by Moskatel and Slusky in 2017. This can help improve the health outcomes for some patients as they are more willing to go to hospitals when fewer hurdles in traffic are there. As one of the patient from San Diego, CA commented in the news “Introducing Uber Health, Removing Transportation as a Barrier to Care” that is published by Uber on May 1, 2018, “my health crisis was a lot to manage. Knowing I had reliable and comfortable transportation to and from my oncology appointments was one less burden on a very long list”.

Obstacles

The major obstacle for using ride-hailing services (like Uber and Lyft) is the demand for drivers, especially in some emergency situation. The drivers may not want to take such orders because of the urgency.

How to Mitigate the Obstacles

To address the obstacle, ride-hailing service providers may set up a special group, like UberX, to serve healthcare transportation only. This helps avoid the above issue of the unwillingness of drivers. At the same time, some professional training may be offered to this group of drivers. Like illustrated by Geisser in 2015, UberX may be designed to offer some rewards and some special responsibilities to help health care transportation.

Conclusion

From the above analysis, it can be seen that addressing the slow response time and the high cost of ambulance services in the United States is a must. Three solutions, including setting up programs of visiting doctors, setting up mobile health centers, and/or integrating ride-hailing providers to partner up with health care providers in offering fast and cheap transportation to and from hospitals, are proposed with analysis of their benefits, obstacles, and ways to mitigate the obstacles. It requires careful planning and consideration of stakeholders in determining and implementing. It is promising for ride-hailing to serve as a compensation for the ambulance service as Georgetown Home Care, a health care provider for elderly patients in Washington has started to use such ride-hailing services to transport patients to and from hospitals with caregivers on their side.

Works Cited

DiGangi, Christine. “This Man's 2-Mile Ambulance Ride Cost $2,700. Is That Normal?” USA Today, Gannett Satellite Information Network, 20 May 2017, www.usatoday.com/story/money/personalfinance/2017/05/20/ambulance-health-care-services-costs/334338001/.

Flanagan, Priti, et al. “Doctors Making House Calls:Innovative Role or Overkill?” The Canadian Journal of Hospital Pharmacy, vol. 63, no. 6, 2010, doi:10.4212/cjhp.v63i6.959.

Flanagan, Priti, et al. “Doctors Making House Calls:Innovative Role or Overkill?” The Canadian Journal of Hospital Pharmacy, vol. 63, no. 6, 2010, doi:10.4212/cjhp.v63i6.959.