Cost and financing of paratransit services and their effect on dissatisfaction with participation in daily activities of persons with disabilities

Introduction: Transportation use affects participation in daily activities, health and well-being. Persons with disabilities rely on paratransit services if they are not able to use public transport. The per-trip costs of paratransit services in Switzerland are high, and the responsibility for financing these trips (e.g., social insurance, canton) varies depending on the purpose of travel. We hypothesized that cost and financing factors of paratransit services increase dissatisfaction with participation in daily activities of persons with disabilities in Switzerland. The study’s objective is to investigate which cost and financing factors affect dissatisfaction with participation in daily activities. Methods: Using a cross-sectional study design, we conducted a self-administered online questionnaire. We included paratransit service users or relatives of paratransit service users aged 18 years or older. We analyzed the data using the multiple correspondence-, lasso- and regression analysis. Results: A statistically significant effect on lower levels of dissatisfaction with participation in daily activities had high costs of paratransit services (Odds ratio (OR) = 3.45, 95% Confidence interval (CI) [1.41, 8.36]), not using paratransit services to leisure activities (OR = 2.39, 95% CI [1.28, 4.58]) and work (OR = 4.11, 95% CI [1.22, 20.89]), and getting trips financed to leisure activities by social insurances and benefits (OR = 3.06, 95% CI [1.08, 8.42]). Conclusion: Concerning the influence of transportation on health and wellbeing, policy-makers and transportation planners may reflect on the effect of cost and financing factors of paratransit services on dissatisfaction with participation in daily activities of persons with disabilities. This is particularly important when the dissatisfaction stems from reduced use of paratransit services for leisure activities, due to high costs.