Eliminating Transportation Barriers to Outpatient Therapy for Underserved Patients with Cancer

Background: The cancer patients of Bellevue Hospital (BH) and Woodhull Hospital (WH) represent an underserved community, and are referred to New York 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 York 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.