Ride-to-health: The impact of ridesharing on patients’ emergency care access

Abstract

Transportation has been one of the obstacles preventing people from obtaining timely and appropriate care. Emergency departments (EDs) are uniquely positioned in the healthcare system, providing around-the-clock care for illnesses and injuries that span a wide spectrum of clinical severity. While transportation is an important factor patients consider when making decisions regarding ED visits, it is unclear a priori whether ridesharing platforms—enabled by new disruptive technology and serving as an alternative transportation option to personal vehicles, public transit, taxis, and ambulances—can alleviate transportation barriers and significantly influence emergency care utilization beyond merely substituting existing transportation methods. This article empirically examines how the entry of ridesharing platforms influences patients’ emergency care utilization patterns, with a particular focus on how the effects vary across visits of different severity levels. We leverage the sequential entries of ridesharing services in different counties in California as a natural experiment setting and use a staggered difference-in-differences model to estimate this impact. We find that ridesharing's entry, on average, significantly increases the number of high-severity ED visits while simultaneously reducing the number of low-severity ED visits. Analyses using additional data provide suggestive evidence that the contrasting effects may be related to improved primary care access. We also observe heterogeneous effects of ridesharing services across hospitals with different ED patient compositions and location characteristics. Additionally, we find a significant increase in ED wait times after ridesharing's entry. Our findings have important managerial and policy implications and contribute to the growing stream of research on ridesharing's societal impact, healthcare access disparities, and ED overcrowding.