Accessibility and utilization patterns of a mobile medical clinic among vulnerable populations.
We mapped mobile medical clinic (MMC) clients for spatial distribution of their self-reported locations and travel behaviors to better understand health-seeking and utilization patterns of medically vulnerable populations in Connecticut. Contrary to distance decay literature, we found that a small but significant proportion of clients was traveling substantial distances to receive repeat care at the MMC. Of 8404 total clients, 90.2% lived within 5 miles of a MMC site, yet mean utilization was highest (5.3 visits per client) among those living 11-20 miles of MMCs, primarily for those with substance use disorders. Of clients making >20 visits, 15.0% traveled >10 miles, suggesting that a significant minority of clients traveled to MMC sites because of their need-specific healthcare services, which are not only free but available at an acceptable and accommodating environment. The findings of this study contribute to the important research on healthcare utilization among vulnerable population by focusing on broader dimensions of accessibility in a setting where both mobile and fixed healthcare services coexist.
Yale University School of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, CT, USA. Electronic address: britton.gibson@yale.edu.
Britton A
BA
Gibson
University of Connecticut, Department of Geography, Storrs, CT, USA. Electronic address: debarchana.ghosh@uconn.edu.
Debarchana
D
Ghosh
Yale University School of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, CT, USA.
Jamie P
JP
Morano
Yale University School of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, CT, USA; Yale University School of Public Health, Division of Epidemiology of Microbial Diseases, New Haven, CT, USA; University of Malaya, Centre of Excellence on Research in AIDS (CERiA), Kuala Lumpur, Malaysia.
Frederick L
FL
Altice
D003237:Connecticut / Q000453:epidemiology; D057286:Electronic Health Records; D005260:Female; D040362:Geographic Information Systems; D015438:Health Behavior; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008952:Mobile Health Units / Q000706:statistics & numerical data*; D012044:Regression Analysis; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D035862:Vulnerable Populations / Q000523:psychology* / Q000706:statistics & numerical data*
Accessibility; Geographic Information System; Mobile medical clinic; Substance use disorders; Vulnerable populations