An Overview of Costs, Utilization, Geographical Distribution & Influence of Mobile Clinics in Rural Healthcare Delivery in the United States
The issue of access in rural areas, defined as the ability to afford healthcare services and have availability, is a concern amidst efforts to reduce the number of uninsured individuals in the United States. Mobile clinics can be used to provide efficient healthcare services in rural areas in states facing rural hospital closures and in those which have a large percentage of uninsured individuals who could be insured if the states expanded Medicaid. However, the use of mobile clinics in healthcare services delivery has not been studied well enough to warrant the implementation of policies to encourage their wider adoption. The study goals are to understand the costs, utilizations and geographic distributions of preventative, primary, mammography and dental mobile clinics and to determine whether they were being utilized in rural areas. A descriptive analysis of the utilization and costs of a sample of mobile clinics identified in Texas, North Carolina, Georgia and Florida was conducted. The states identified in the study have not expanded Medicaid and have a large proportion of individuals that are uninsured. In addition they currently have 26 rural hospital closures. A graphical distribution of the rural or urban locations of the mobile clinics was also described in the study. Finally, a geographic measure of the influence of mobile clinics in primary healthcare delivery in rural areas was ascertained via a rural primary care provider mobile clinic index and stakeholder interview. Most of the clinics were owned by for-profit organizations (37%) and 39% were privately funded. Demographic data showed clinics saw an equal distribution of males and females and African Americans, Caucasians, and Hispanics were the highest percent of race and ethnicities reported by clinics in the study (53%). Most individuals were reported by the clinics as having some type of insurance, with only 2% of the clinics having a population of patients that were solely uninsured. Dental healthcare delivery had the lowest median cost per patient, had the highest annual number of patients in the study sample, and was mostly in urban areas. The overall costs of all delivery types for a population with various insurance types in the mobile clinics in Texas, Florida, North Carolina, and Texas were lower than the costs of providing care to Medicare beneficiaries in federally funded health centers. Most of the mobile clinics were located in urban areas although both the rural primary care mobile clinic index and narrative findings support the important role of mobile clinics in rural areas in the delivery of healthcare.
Attipoe-Dorcoo, Sharon, "An Overview of Costs, Utilization, Geographical Distribution & Influence of Mobile Clinics in Rural Healthcare Delivery in the United States" (2018). Texas Medical Center Dissertations (via ProQuest). AAI10928004.