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 b...
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| Veröffentlicht in: | Health & place 2014-07, Vol.28, p.153-166 |
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| creator | Gibson, Britton A. Ghosh, Debarchana Morano, Jamie P. Altice, Frederick L. |
| description | 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.
•We map the client׳s place of origin of a mobile medical clinic (MMC).•We examine spatial accessibility to other drug treatment centers for MMC clients.•We compare factors related to accessing care for drug treatment.•A minority of clients is traveling sizable distance with frequent utilization.•High frequency MMC users show overlap of substance abuse, violence, and AIDS. |
| doi_str_mv | 10.1016/j.healthplace.2014.04.008 |
| format | Article |
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•We map the client׳s place of origin of a mobile medical clinic (MMC).•We examine spatial accessibility to other drug treatment centers for MMC clients.•We compare factors related to accessing care for drug treatment.•A minority of clients is traveling sizable distance with frequent utilization.•High frequency MMC users show overlap of substance abuse, violence, and AIDS.</description><identifier>ISSN: 1353-8292</identifier><identifier>EISSN: 1873-2054</identifier><identifier>DOI: 10.1016/j.healthplace.2014.04.008</identifier><identifier>PMID: 24853039</identifier><identifier>CODEN: HEPLFG</identifier><language>eng</language><publisher>Amsterdam: Elsevier Ltd</publisher><subject>Accessibility ; Biological and medical sciences ; Clinics ; Connecticut - epidemiology ; Customers ; Electronic Health Records ; Environment. Living conditions ; Female ; Geographic Information System ; Geographic Information Systems ; Geographical information systems ; Health Behavior ; Health care ; Health services ; Health Services Accessibility - statistics & numerical data ; Helpseeking ; Humans ; Male ; Medical sciences ; Mobile Health Units - statistics & numerical data ; Mobile Health Units - utilization ; Mobile medical clinic ; Mobile phones ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Regression Analysis ; Spatial distribution ; Substance Abuse Treatment Centers - statistics & numerical data ; Substance use disorders ; Substance-Related Disorders - epidemiology ; Substance-Related Disorders - psychology ; Substance-Related Disorders - therapy ; Travel ; Vulnerable people ; Vulnerable populations ; Vulnerable Populations - psychology ; Vulnerable Populations - statistics & numerical data</subject><ispartof>Health & place, 2014-07, Vol.28, p.153-166</ispartof><rights>2014 Elsevier Ltd</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2014 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c645t-84affcbbbb4eb3a178848f58b92cbf66e584500f2fb7e637b58786eb28f574f3</citedby><cites>FETCH-LOGICAL-c645t-84affcbbbb4eb3a178848f58b92cbf66e584500f2fb7e637b58786eb28f574f3</cites><orcidid>0000-0003-0058-4272</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.healthplace.2014.04.008$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3548,27922,27923,30998,45993</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28569005$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24853039$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gibson, Britton A.</creatorcontrib><creatorcontrib>Ghosh, Debarchana</creatorcontrib><creatorcontrib>Morano, Jamie P.</creatorcontrib><creatorcontrib>Altice, Frederick L.</creatorcontrib><title>Accessibility and utilization patterns of a mobile medical clinic among vulnerable populations</title><title>Health & place</title><addtitle>Health Place</addtitle><description>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.
•We map the client׳s place of origin of a mobile medical clinic (MMC).•We examine spatial accessibility to other drug treatment centers for MMC clients.•We compare factors related to accessing care for drug treatment.•A minority of clients is traveling sizable distance with frequent utilization.•High frequency MMC users show overlap of substance abuse, violence, and AIDS.</description><subject>Accessibility</subject><subject>Biological and medical sciences</subject><subject>Clinics</subject><subject>Connecticut - epidemiology</subject><subject>Customers</subject><subject>Electronic Health Records</subject><subject>Environment. Living conditions</subject><subject>Female</subject><subject>Geographic Information System</subject><subject>Geographic Information Systems</subject><subject>Geographical information systems</subject><subject>Health Behavior</subject><subject>Health care</subject><subject>Health services</subject><subject>Health Services Accessibility - statistics & numerical data</subject><subject>Helpseeking</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mobile Health Units - statistics & numerical data</subject><subject>Mobile Health Units - utilization</subject><subject>Mobile medical clinic</subject><subject>Mobile phones</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Regression Analysis</subject><subject>Spatial distribution</subject><subject>Substance Abuse Treatment Centers - statistics & numerical data</subject><subject>Substance use disorders</subject><subject>Substance-Related Disorders - epidemiology</subject><subject>Substance-Related Disorders - psychology</subject><subject>Substance-Related Disorders - therapy</subject><subject>Travel</subject><subject>Vulnerable people</subject><subject>Vulnerable populations</subject><subject>Vulnerable Populations - psychology</subject><subject>Vulnerable Populations - statistics & numerical data</subject><issn>1353-8292</issn><issn>1873-2054</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqNkV9rFDEUxQdRbK1-BYkPgi-z5u9M5kUoi61CwZc-G5LsTTdLJhmTmYX66c1211rfGi7kwv3dw0lO03wgeEUw6T7vVlvQYd5OQVtYUUz4CtfC8kVzTmTPWooFf1l7Jlgr6UDPmjel7DDGneTkdXNGuRQMs-G8-XlpLZTijQ9-vkc6btAy1_63nn2KaNLzDDkWlBzSaEwVAzTCxlsdkA0-eov0mOId2i8hQtamzqc0LeFhv7xtXjkdCrw73RfN7dXX2_W39ubH9ff15U1rOy7mVnLtnDX1cDBMk15KLp2QZqDWuK4DIbnA2FFneuhYb4TsZQeGVqjnjl00X46y02KqOwtxzjqoKftR53uVtFf_T6Lfqru0V5z3gnFZBT6dBHL6tUCZ1eiLhRB0hLQURYQgmDGBxXNQPEhBJa3ocERtTqVkcI-OCFaHJNVOPUlSHZJUuBY-OHr_9EmPm3-jq8DHE6BLTcNlHa0v_zgpugE_-F0fOaj_v_eQVbEeoq0hZrCz2iT_DDt_ANRwxVA</recordid><startdate>20140701</startdate><enddate>20140701</enddate><creator>Gibson, Britton A.</creator><creator>Ghosh, Debarchana</creator><creator>Morano, Jamie P.</creator><creator>Altice, Frederick L.</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>8BJ</scope><scope>FQK</scope><scope>JBE</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-0058-4272</orcidid></search><sort><creationdate>20140701</creationdate><title>Accessibility and utilization patterns of a mobile medical clinic among vulnerable populations</title><author>Gibson, Britton A. ; Ghosh, Debarchana ; Morano, Jamie P. ; Altice, Frederick L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c645t-84affcbbbb4eb3a178848f58b92cbf66e584500f2fb7e637b58786eb28f574f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Accessibility</topic><topic>Biological and medical sciences</topic><topic>Clinics</topic><topic>Connecticut - epidemiology</topic><topic>Customers</topic><topic>Electronic Health Records</topic><topic>Environment. Living conditions</topic><topic>Female</topic><topic>Geographic Information System</topic><topic>Geographic Information Systems</topic><topic>Geographical information systems</topic><topic>Health Behavior</topic><topic>Health care</topic><topic>Health services</topic><topic>Health Services Accessibility - statistics & numerical data</topic><topic>Helpseeking</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mobile Health Units - statistics & numerical data</topic><topic>Mobile Health Units - utilization</topic><topic>Mobile medical clinic</topic><topic>Mobile phones</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Regression Analysis</topic><topic>Spatial distribution</topic><topic>Substance Abuse Treatment Centers - statistics & numerical data</topic><topic>Substance use disorders</topic><topic>Substance-Related Disorders - epidemiology</topic><topic>Substance-Related Disorders - psychology</topic><topic>Substance-Related Disorders - therapy</topic><topic>Travel</topic><topic>Vulnerable people</topic><topic>Vulnerable populations</topic><topic>Vulnerable Populations - psychology</topic><topic>Vulnerable Populations - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gibson, Britton A.</creatorcontrib><creatorcontrib>Ghosh, Debarchana</creatorcontrib><creatorcontrib>Morano, Jamie P.</creatorcontrib><creatorcontrib>Altice, Frederick L.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>International Bibliography of the Social Sciences</collection><collection>International Bibliography of the Social Sciences</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Health & place</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gibson, Britton A.</au><au>Ghosh, Debarchana</au><au>Morano, Jamie P.</au><au>Altice, Frederick L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Accessibility and utilization patterns of a mobile medical clinic among vulnerable populations</atitle><jtitle>Health & place</jtitle><addtitle>Health Place</addtitle><date>2014-07-01</date><risdate>2014</risdate><volume>28</volume><spage>153</spage><epage>166</epage><pages>153-166</pages><issn>1353-8292</issn><eissn>1873-2054</eissn><coden>HEPLFG</coden><abstract>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.
•We map the client׳s place of origin of a mobile medical clinic (MMC).•We examine spatial accessibility to other drug treatment centers for MMC clients.•We compare factors related to accessing care for drug treatment.•A minority of clients is traveling sizable distance with frequent utilization.•High frequency MMC users show overlap of substance abuse, violence, and AIDS.</abstract><cop>Amsterdam</cop><pub>Elsevier Ltd</pub><pmid>24853039</pmid><doi>10.1016/j.healthplace.2014.04.008</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0003-0058-4272</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Health & place, 2014-07, Vol.28, p.153-166 |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | Accessibility Biological and medical sciences Clinics Connecticut - epidemiology Customers Electronic Health Records Environment. Living conditions Female Geographic Information System Geographic Information Systems Geographical information systems Health Behavior Health care Health services Health Services Accessibility - statistics & numerical data Helpseeking Humans Male Medical sciences Mobile Health Units - statistics & numerical data Mobile Health Units - utilization Mobile medical clinic Mobile phones Public health. Hygiene Public health. Hygiene-occupational medicine Regression Analysis Spatial distribution Substance Abuse Treatment Centers - statistics & numerical data Substance use disorders Substance-Related Disorders - epidemiology Substance-Related Disorders - psychology Substance-Related Disorders - therapy Travel Vulnerable people Vulnerable populations Vulnerable Populations - psychology Vulnerable Populations - statistics & numerical data |
| title | Accessibility and utilization patterns of a mobile medical clinic among vulnerable populations |
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