Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-16-2025

Graduate Advisor

Joshua Minks

Co-Advisor

Keri Jupka

Committee

Jessica Goins

Abstract

Problem: Transportation is essential for health service utilization (clinic appointments, diagnostic services, and picking up medications from the pharmacy (Hansmann & Razon, 2024). Shekelle et al. (2022) in their systematic review and meta-analysis indicated that the U.S. rural population is 60 million. Rural areas continue to experience transportation as a significant barrier to health, a key social determinant of health. It causes delayed or foregone care in approximately 3.6 million people annually, resulting in more than 25% of missed appointments. Methods: This quality improvement project utilized a descriptive and observational design. A convenience sample of Medicaid patients receiving care at Mercy Family Clinic in Wright City was identified, and qualitative data were collected during the implementation period. The data collected included the patients’ age group, the number of times non-emergency medical transportation (NEMT) was offered, the distance from home to the clinic, the number of emergency room (ER) visits, and the diagnoses. Results: With the implementation of the quality project, thirty-two Medicaid patients were seen and reminded of the availability of NEMT. Of those, three missed their appointments, 9.3% (n=3). Implications for Practice: Interventions aimed at closing the transportation gap in rural areas are crucial for improving the health outcomes of this population by reducing the number of missed appointments.

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