Transportation barriers, emergency department use, and mortality risk among us adults: a national health interview survey analysis

作者：Fangyuan Chen, Ryan David Nipp, Xuesong Han, Zhiyuan Zheng, K. Robin Yabroff, Tianci Wang, Changchuan Jiang · 发表于：BMC Public Health · 年份：2025 · DOI：10.1186/s12889-025-24670-4 · 被引用次数：3 · 研究领域：Healthcare Policy and Management、Health disparities and outcomes、Emergency and Acute Care Studies

OBJECTIVES: To estimate the prevalence of transportation barriers to care among patients with common chronic health conditions and examine associations between transportation barriers with the outcomes of emergency department use and all-cause mortality risk using a large, nationally representative cohort in the United States. METHODS: We used weighted logistic and Cox regression to assess the association of transportation barriers, ED use and all-cause mortality, in 440,249 US adults aged 18–79 from the 2002–2018 National Health Interview Survey (NHIS) and linked mortality data. RESULTS: Transportation barrier was higher in adults with chronic health conditions (history of hypertension, cardiac diseases, chronic obstructive pulmonary disease (COPD)/asthma, class III obesity, diabetes, and cancer). It was also associated with increased risk of emergency department use (age 18–64: odds ratio (OR) = 1.45, 95% confidence interval (CI):1.41–1.50; age 65+: OR = 1.34, 95%CI:1.26–1.42), and all-cause mortality (age 18–64: hazard ratio (HR) = 1.36, 95%CI:1.24–1.49; age 65+: HR = 1.30, 95%CI:1.15–1.47). These associations also hold in subgroups with all chronic health conditions, except older adults with cancer history. CONCLUSIONS: Transportation barriers disproportionally burdened adults with chronic health conditions, which warrant effective screening for and interventions against transportation barriers for individuals with chronic diseases.