Putting mobile on the map, mapping the impact of this non-traditional health service delivery system

Background:Mobile Health Clinics (MHCs) play a significant yet unmeasured role within the health care system. It is estimated that there are 2000 MHCs across America. Through their flexibility, they are able to fill the niches missed by traditional health care delivery systems. However the depth and breath of their penetration across the country and into the populations with the highest burden of disease were unknown. Objectives: to measure the penetration of Mobile Health Clinics: including the geographic distribution, the penetration into communities with the highest burden of disease and the aggregate services delivered. Methods: MHCs were invited to test a web-based tool, with mapping capability, directory functionality and an embedded tool for calculating cost-effectiveness. Clinics entered one year's of data including: location, demographic profile of population served, aggregate number of patients served and cost of service delivery. Results: 123 MHC from 32 states, the majority operating in communities with a high disease burden, entered partial data. Of these, 25 from 13 states entered full data and collectively served 103,732 visitors. Of these clients, 53% were female, 56% under-represented minorities, 61% uninsured and 24% with government insurance. In aggregate they provided, 142,690 proven cost-effective prevention and screening services or 1.9 services per clinical encounter. Conclusions: This pilot study of a self-selected sample MHCs demonstrates that MHC are widely distributed across the USA, provide services to a large number of people in medically underserved communities including minority populations and the uninsured.