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Background: Transportation access is a social determinant of health that impedes chronic care engagement for vulnerable populations. Few studies have examined transportation interventions on healthcare outcomes in isolation, and data is further limited for rideshare initiatives. Methods: We conducted a retrospective, descriptive analysis of a Lyft rideshare program for pre- and post-operative patients as part of a quality improvement (QI) initiative at a California county hospital. We assessed the population that benefited from this rideshare program and compared outcomes between program participants and non-participants. Variables obtained included demographic data, effects of health care utilization (e.g., delays and case cancellations in the operating room (OR)), and costs to the hospital (e.g., Lyft rides and delayed OR time). Results: Inclusion criteria resulted in 4,150 total patients, 376 in the rideshare group and 3,774 in the non-rideshare group. Rideshare group patients were more likely to be male and black/African American, and less likely to be Hispanic/Latino and require interpreter use. Participating and non-participating patients in the rideshare program did not differ significantly in the proportion of OR cases starting on time (22.8% and 20.6%, respectively) or average time delayed in OR case start times (16.97 and 17.03 minutes, respectively). Costs associated with rideshare services ($17.06/ride) were outweighed by costs from OR delays ($36-37/minute) and rideshare patients did not cost significantly more to the hospital ($636.54) than non-rideshare patients ($621.56). Conclusions: Our study supports that rideshare programs can address transportation barriers for vulnerable communities without significantly greater financial costs to the healthcare system. Future work is required to examine potential health benefits from transportation interventions, particularly those based in rideshare initiatives.

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