Mobile health is worth it! Economic benefit and impact on health of a population-based mobile screening program in new Mexico.
BACKGROUND
HABITS for Life was a 3-year initiative to broadly deliver a statewide biometric and retinal screening program via a mobile unit throughout New Mexico at no charge to participants. The program goal-to identify health risk and improve population health status-was tested over a 3-year period. Value to participants and impact to the healthcare system were measured to quantify impact and value of investing in prevention at the community level.


METHODS
We used the Mobile Health Map Return-on-Investment Calculator, a mobile screening unit, biometric screening, retinography, and community coordination. Our systems included satellite, DSL, and 3G connectivity, a Tanita® (Arlington Heights, IL) automated body mass index-measuring scale, the Cholestec® (Alere™, Waltham, MA) system for biomarkers and glycosylated hemoglobin, a Canon (Melville, NY) CR-1 Mark II camera, and the Picture Archiving Communication System.


RESULTS
In this report for the fiscal year 2011 time frame, 6,426 individuals received biometric screening, and 5,219 received retinal screening. A 15:1 return on investment was calculated; this excluded retinal screening for the under-65 year olds, estimated at $10 million in quality-adjusted life years saved. Statistically significant improvement in health status evidenced by sequential screening included a decrease in total cholesterol level (p=0.002) (n=308) and an increase in high-density lipoprotein level after the first and second screening (p=0.02 and p=0.01, respectively), but a decrease in mean random glucose level was not statistically significant (p=0.62). Retinal results indicate 28.4% (n=1,482) with a positive/abnormal finding, of which 1.79% (n=93) required immediate referral for sight-threatening retinopathy and 27% (n=1,389) required follow-up of from 3 months to 1 year.


CONCLUSIONS
Screening programs are cost-effective and provide value in preventive health efforts. Broad use of screening programs should be considered in healthcare redesign efforts. Community-based screening is an effective strategy to identify health risk, improve access, provide motivation to change health habits, and improve physical status while returning significant value.
Project HOPE , HABITS for LIFE Program, Albuquerque, New Mexico .
Nancy E
NE
Brown-Connolly
Jeannie B
JB
Concha
Jennifer
J
English
D000368:Aged; D001786:Blood Glucose; D001794:Blood Pressure; D015992:Body Mass Index; D001837:Body Weights and Measures; D002784:Cholesterol / Q000097:blood; D003362:Cost-Benefit Analysis; D003920:Diabetes Mellitus / Q000175:diagnosis*; D003941:Diagnostic Techniques, Ophthalmological / Q000191:economics*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000379:methods; D008875:Middle Aged; D008952:Mobile Health Units / Q000191:economics* / Q000458:organization & administration; D018803:Models, Economic; D009516:New Mexico; D019057:Quality-Adjusted Life Years; D017216:Telemedicine / Q000191:economics* / Q000379:methods
D001786:Blood Glucose; D002784:Cholesterol