Transportation preferences of patients discharged from the emergency department in the era of ridesharing apps

Abstract

Introduction: Patients discharged from the emergency department (ED) may encounter difficulty finding transportation home, increasing length of stay and ED crowding. We sought to determine the preferences of patients discharged from the ED with regard to their transportation home, and their awareness and past use of ridesharing services such as Lyft and Uber. Methods: We performed a prospective, survey-based study during a five-month period at a university-associated ED and Level I trauma center serving an urban area. Subjects were adult patients who were about to be discharged from the ED. We excluded patients requiring ambulance transport home. Results: Of 500 surveys distributed, 480 (96%) were completed. Average age was 47 ± 19 years, and 61% were female. There were 33,871 ED visits during the study period, and 67% were discharged home. The highest number of subjects arrived by ambulance (27%) followed by being dropped off (25%). Of the 408 (85%) subjects aware of ridesharing services, only eight (2%) came to the ED by this manner; however, 22 (5%) planned to use these services post-discharge. The survey also indicated that 377 (79%) owned smartphones, and 220 (46%) used ridesharing services. The most common plan to get home was with family/friend (35%), which was also the most preferred (29%). Regarding awareness and past use of ridesharing services, we were unable to detect any gender and/or racial differences from univariate analysis. However, we did detect age, education and income differences regarding awareness, but only age and education differences for past use. Logistic regression showed awareness and past use decreased with increasing patient age, but correlated positively with increasing education and income. Half the subjects felt their medical insurance should pay for their transportation, whereas roughly one-third felt ED staff should pay for it. Conclusion: Patients most commonly prefer to be driven home by a family member or friend after discharge from the ED. There is awareness of ridesharing services, but only 5% of patients planned to use these services post-discharge from the ED. Patients who are older, have limited income, and are less educated are less likely to be aware of or have previously used ridesharing services. ED staff may assist these patients by hailing ridesharing services for them at time of discharge.