Trip Decisions and Mode Choices to Out-patient Health Care Facilities

Patrick McCarthy
About This Project

Patrick McCarthy headshotBy Gita Smith

Health care decisions intersect with economics every time a person makes a trip to a medical outpatient facility. But what are the factors determining patients’ decisions to travel and their choices of transport mode? To find answers, Georgia Tech School of Economics emeritus professor Patrick McCarthy analyzed data from the China Health and Retirement Longitudinal Study for the years 2011, 2013 and 2015, for persons aged 45 years and up. Separate studies made in New Zealand and the USA confirm that older populations have more health-related problems than younger populations do, leading to more visits to doctors' offices, clinics and hospitals.

McCarthy’s study pinpoints key indicators that influence trip and mode decisions. They are trip purpose (vaccinations versus treatment, for example), the necessity for insurance, an ability to pay out-of-pocket costs and whether the facility is public or private. Time needed for a trip and cost also influence choices. Relative to out-patient trips for immunization and consulting, trips for treating illnesses increase the probability by 52 points, and trips for check-ups increase the probability of making the trip by 31 probability points. And the probability of patients making a trip to a public health care facility than to a private one increases by 8 points.

Physical mobility difficulties, high blood pressure and drinking behaviors have modest but discernible effects upon one's decision to travel to an out-patient facility. Regarding mode of travel, data from 2015 showed that physical mobility difficulties reduced the likelihood of walk-related or bicycle trips, and high blood pressure increased the likelihood of a car and bicycle trip more than an electric bicycle, motorcycle or walk trip. McCarthy states that many studies find an inverse relationship between physical activity and car commuting with a positive relationship between obesity and time spent in passenger cars. He notes the evidence that public transit users are healthier and that active (walking, cycling) transport users have lower rates of obesity with significant body-mass index (BMI) benefits to commuters who switch from private motor vehicle to public transportation.

McCarthy’s work is relevant because health care infrastructure is of increasing importance with the aging of the world population: In 2019, 702.9 million individuals worldwide were 65 or older, with an expected increase to 1.55 billion in 2050. Outpatient care facilities (as well as transport infrastructures) must keep pace to serve this global population segment.

"Trip and mode choice decisions to out-patient health care facilities: A longitudinal analysis" appeared in the Journal of Management Science and Engineering in May 2021. 

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