Table 2.

Multilevel consequences of transportation insecurity for patients with cancer

Stakeholder	Consequences
Patient	Delays in screening, seeking medical attention, and along the cancer care continuum; stage migration
	Treatment nonadherence (ie, forego, miss, delay, alter, or prematurely terminate necessary cancer care)
	Direct cost of travel; opportunity cost of missed work and other activities
	Inability to participate in clinical trials
	Increased distress, decreased quality of life
	Higher rates of cancer recurrence; worse survival
Informal caregiver	Increased distress, decreased quality of life
	Delays in own care
	Direct cost of travel; opportunity cost of missed work
Physician	Inefficiencies of missed appointments
	Stress of rescheduling
	Need to restructure treatment pathways and protocols
Health system	Outpatient: lost revenue through increased work to reschedule patients or make alternative arrangements, underutilization, and vacancies (clinic, infusion suites, radiology)
	Inpatient: inefficiencies in discharge times and hospital or health-care facility throughput
	Lower patient satisfaction (outpatient and inpatient settings)
Society	Inefficient use of health-care resources
	Loss of productivity
	Disparities in cancer outcomes
	Potentially avoidable mortality