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 Table of Contents  
REVIEW ARTICLE
Year : 2016  |  Volume : 4  |  Issue : 1  |  Page : 1-5

Investigation of mobile clinics and their challenges


1 Iranian Social Security Organization, Isfahan, Iran
2 Research Institute of Shakhes Pajouh, Isfahan, Iran

Date of Web Publication5-Feb-2016

Correspondence Address:
Rahele Samouei
Research Institute of Shakhes Pajouh, Isfahan
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2347-9019.175669

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  Abstract 


Introduction: Given the importance of medical services and health care in societies and the difficulty of accessing suitable health services for people living in remote locations. Aim: The goal of this study reviewed the challenges faced when creating mobile clinics to understand the challenges and provide accessible and feasible medical care in remote locations. Methods: This study used Review method to search for Persian and international articles between years 2004 and 2014 with keywords mobile specialized clinics, mobile clinic, health care, and mobile health care in credible websites and databases including PubMed, Science Direct, Google Scholar, Web of Sciences, and extract the report the relevant information from these articles. Results: Mobile clinics are an important proposal in health and medical systems and provide advantages such as accessibility, variety of services, and the possibility of providing health care for remote or underprivileged locations and during disasters while having disadvantages such as structural, procedural and financial problems, lacking certain tools and specializations and unwillingness of people for using these clinics. Conclusion: Given the strengths of mobile clinics in provision a variety of medical services and disease prevention, the possibility of contacting other medical centers in order to improve the quality of services and reduction of costs, these clinics are able to answer some of the medical needs of people and their weaknesses can be reduced with the help of proper laws, planning and a feedback system in order to determine the quality of services. It is possible to improve the effectiveness of these clinics and provide services that are in line with the needs of the target population.

Keywords: Health care, health service, mobile clinic


How to cite this article:
Abbasi S, Mohajer H, Samouei R. Investigation of mobile clinics and their challenges. Int J Health Syst Disaster Manage 2016;4:1-5

How to cite this URL:
Abbasi S, Mohajer H, Samouei R. Investigation of mobile clinics and their challenges. Int J Health Syst Disaster Manage [serial online] 2016 [cited 2019 Jan 18];4:1-5. Available from: http://www.ijhsdm.org/text.asp?2016/4/1/1/175669




  Introduction Top


Nowadays, most organizations consider the satisfaction factor to be a key component of their activities and try to use this factor to improve the quality of their services.[1] Therefore, most countries of the world with widespread and diverse populations and remote or underprivileged locations try to provide mobile medical care and health services in various locations to improve the satisfaction of their citizens.[2] In recent years, the creation of mobile clinics are considered in health care policies of many countries.[3] These mobile clinics contain a collection of medical and health services and have various uses in suitable and disaster situations, often have the necessary equipment for temporary admitting and treating patients in critical situations and sometimes have the necessary equipment for specialized medical services, creating specialized mobile clinics.[4] The creation of these mobile clinics improves the overall quality of medical services and improves access to basic medical needs [5] and also provides underprivileged patients with access to better health care and medical equipment.[6] Therefore, the main customers of these mobile clinics are people living in areas that lack proper health care infrastructure which in most cases include underprivileged or elderly patients who are not able to seek medical attention at a different location.[5]

Mobile clinics are useful for providing health care for underprivileged people, those with mental problems, immigrants, and addicts among other groups.[7] In some rural areas, the quality and conditions of roads and lack of proper transportation necessitates the presence of mobile clinics especially for elderly patients, pregnant women, and children that are in need of constant medical attention.[5] Following the general strategy of improved health care, these clinics make it possible to access to basic and sometimes specialized health care services regardless of location, local medical equipment, the financial situation of patients, type of health care, and structural barriers such as problems in transferring patients from remote locations.[8]

Due to the fact that several studies have investigated the strengths and weaknesses of these clinics and have aimed to answer questions such as whether these clinics can answer the basic medical needs of people given their positive and negative points. Therefore, the current study aimed to investigate the challenges of mobile clinics from the point of view of various studies.


  Methods Top


This study used review method and was conducted in the year 2015. In this study, all articles published between years 2004 and 2014 about specialized mobile clinics in various countries were investigated. In Iran, only a few reports existed about this subject and no scientific studies were carried out about mobile clinics in Iran. Therefore, all articles used in this study were extracted from English sources. Search was done keywords include specialized mobile clinic, mobile clinic, health care, and mobile health care in credible scientific databases including Web of Science, Google Scholar, Science Direct and PubMed database. The related articles were then investigated, and relevant information was extracted, analyzed, and categorized.


  Results Top


The findings of this study were categorized based on four categories of the main goal, study population, main results, and strengths and weaknesses of each proposal [Table 1].
Table 1: The implement of mobile clinics with emphasis on strengths and weaknesses

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  Discussion Top


Mobile clinics represent an integral component of the healthcare system that delivers care to populations that are hard to reach by the traditional system, improving access and supporting prevention and chronic disease management. Mobile clinics are able to leverage their ability to overcome barriers to access and build trusting relationships to reduce disparities, improve health, and reduce costs.[3]

Providing suitable and timely services is one of the main challenges in the health care system of every country. In the last few decades, mobile specialized clinics using volunteer personally and operating in critical situations have been introduced as a strategy for providing patients with their basic needs.[20] Every new plan or strategy can have strengths and weaknesses that come to light before, during or after its implementation, making constant evaluation a necessary step in avoiding most challenges and complications. Mobile clinic projects that have been implemented in various countries have both shown great success and been the subject of many criticisms.

The results of various studies were investigated in order to answer the question of “what are the strengths and weaknesses of mobile clinics?” Various studies by Cheong, Rana, George, Hill et al., Vavasis et al., Campos and Olmstead-Rose, Dash, Aljasir and Alghamdi, Krol et al. and Kahn et al. had investigated the strengths and weaknesses of mobile clinics.[2],[5],[9],[10],[11],[14],[15],[16],[17],[19] According to these studies, the advantages and strengths of mobile clinics include variety and diversity of provided services and providing services for various groups of people such as people with various social problems in both urban and rural areas, at all levels and for both acute and chronic diseases.[2] Concentrating on screening and prevention is among other advantages of mobile clinic projects that can improve the health situation.[17]

In another study, providing health care services for the underprivileged and poor population, those without health insurance and vulnerable groups such as women, children, and teenagers have been considered among the positive aspects of mobile clinics.[21] These social groups often receive less attention from health care providers due to lack of fundamental rights or social vulnerability and, therefore, are among the most vulnerable groups during problems, injuries, and accidents and have less opportunities for seeking proper medical aid. This lack of support can, in turn, lead to new problems or worsening of the previous ones. Furthermore, due to the mobile nature of these clinics providing health services and answering the needs of these groups will be easier to accomplish.[13]

Despite the strengths of these mobile clinics, some studies such as ones by Zirui Song, Dash, Aljasir and Alghamdi, Salah-Eideen and Al-Attar point out the weaknesses of these projects as well.[5],[12],[17],[18] These weaknesses include repeated changes in macro level of medical policies, lack of sufficient evidence about feasibility of these clinics, presence of interfering factors such as other health care institutions, lack of government's commitment in funding these clinics and improper distribution of resources, lack of planning about periodical evaluation of these clinics, lack of certain facilities such as facilities for disabled patients, electrocardiograph and vaccination, lack of dedicated funding and professional personal and sometimes the unwillingness of population for using the services of these clinics.

A look at various studies shows that most of the challenges of mobile clinics stems from policy making and current laws and lack of a defined framework for these clinics in the plans of health care providers. Undoubtedly by defining mobile clinic projects as part of the health care infrastructure, the necessary laws, guidelines, and regulations will also be created. This can also reduce repeated projects and help save time, energy, and resources and also helps in defining the duties of mobile clinics. Another important reason for mobile clinic limitations is a lack of financial resources which causes problems in the effectiveness of these clinics. It is necessary to mention that proper planning and policies can also help in financial backing of these clinics. Therefore, and given the increase in the population, the possibility of increasing the number of active mobile clinics with the help of other health centers and insurance companies is the most important challenge faced by these clinics.


  Conclusion Top


The results of various studies about different mobile clinic projects showed that these clinics have several strengths and weaknesses. The main strength of these clinics is their ability in providing health care for people in locations removed from traditional health care facilities or those that cannot use normal health care due to various financial or social reasons. On the other hand, unclear place of mobile clinics in health care system, uncertain and unclear infrastructure, and procedures and lack of necessary recourses are among the factors that reduce the effectiveness of mobile clinics.

Given the characteristics of mobile clinics and due to the need for providing quick, suitable, and quality health services in disaster situations especially because of unavailability of most common health care clinics during these situations, it is suggested for disaster relief plans to include mobile health care clinics. Furthermore, due to the sensitive nature of these situations, simulations, and exercise are a suitable method for understanding the limitations of these clinics in disaster situations in order to improve the quality of provided services. These mobile clinics can also be useful in other situations such as in remote rural areas, during scientific studies on different populations and other similar situations.

This review study is based on the studies of other researchers and involved no direct intervention or survey and as such proper care needs to be taken in the generalization of the provided information.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.





 
  References Top

1.
Kaplan RS, Norton DP. The Strategy-Focused Organization: How Balanced Scorecard Companies Thrive in the New Business Environment. Boston, Massachusetts: Harvard Business Publication; 2000.  Back to cited text no. 1
    
2.
Krol DM, Redlener M, Shapiro A, Wajnberg A. A mobile medical care approach targeting underserved populations in post-Hurricane Katrina Mississippi. J Health Care Poor Underserved 2007;18:331-40.  Back to cited text no. 2
    
3.
Hill C, Zurakowski D, Bennet J, Walker-White R, Osman JL, Quarles A, et al. Knowledgeable Neighbors: A mobile clinic model for disease prevention and screening in underserved communities. Am J Public Health 2012;102:406-10.  Back to cited text no. 3
    
4.
Norouzi MT. Culture of security defense. Tehran: Sana Publication; 2006.  Back to cited text no. 4
    
5.
Aljasir B, Alghamdi MS. Patient satisfaction with mobile clinic services in a remote rural area of Saudi Arabia. East Mediterr Health J 2010;16:1085-90.  Back to cited text no. 5
    
6.
ICRC. Mobile Health Units: Methodological Approach. Geneva, Switzerland: ICRC; 2006.  Back to cited text no. 6
    
7.
Collinson S, Ward R. A nurse-led response to unmet needs of homeless migrants in inner London. Br J Nurs 2010;19:36-41.  Back to cited text no. 7
    
8.
Hastings J, Zulman D, Wali S. UCLA mobile clinic project. J Health Care Poor Underserved 2007;18:744-8.  Back to cited text no. 8
    
9.
Cheong K. New Mobile Community Health Centre will Benefit Patients with Diabetes, Chronic Illness. SPH Digital News/Copyright © 2015 Singapore Press Holdings Ltd. Co. Regn. No. 198402868E; 2015.  Back to cited text no. 9
    
10.
Rana M. Monthly Report on Aachol Mobile Health Clinic Project; 2014.  Back to cited text no. 10
    
11.
George S. IHI Teams up with Leading Mobile Health Clinics to Spotlight Innovative Approaches to Improving Health and Health Care Services, the Institute for Healthcare Improvement; 2014.  Back to cited text no. 11
    
12.
Song Z, Hill C, Bennet J, Vavasis A, Oriol NE. Mobile clinic in Massachusetts associated with cost savings from lowering blood pressure and emergency department use. Health Aff (Millwood) 2013;32:36-44.  Back to cited text no. 12
    
13.
Gibson BA, Ghosh D, Morano JP, Altice FL. Accessibility and utilization patterns of a mobile medical clinic among vulnerable populations. Health Place 2014;28:153-66.  Back to cited text no. 13
    
14.
Hill CF, Powers BW, Jain SH, Bennet J, Vavasis A, Oriol NE. Mobile health clinics in the era of reform. Am J Manag Care 2014;20:261-4.  Back to cited text no. 14
    
15.
Vavasis A, Oriol N, Bennet J, Cote P, De Lorenzo DA, Hill C. 'Mobile Health Clinics in the United States', Report for the U.S. Department of Health and Human Services, 2013. Office of Minority Health; 2013. Available from: http://www.mobilehealthmap.org. [Last accessed on 2013 Jan 08].  Back to cited text no. 15
    
16.
Campos MM, Olmstead-Rose L. Mobile Health Clinics: Increasing Access to Care in Central and Eastern Contra Costa County, Prepared for East and Central County Health Access Action Team; 2012.  Back to cited text no. 16
    
17.
Dash U, Muraleedharan VR, Prasad BM, Dash SD, Acharya D, Lakshminarasimhan S. Access to Health Services in Under Privileged Areas. A Case Study of Mobile Health Units in Tamil Nadu and Orissa; Oct, 2008. Available from: http://www.crehs.lshtm.ac.uk/downloads/publications/Mobile_health_units.pdf. [Last accessed on 2011 Dec 10].  Back to cited text no. 17
    
18.
Ghada S-E, Al-Attar TS. 10 Years After Introducing Mobile Clinics in Assuit, Egypt. Population Reference Bureau; 2009.  Back to cited text no. 18
    
19.
Kahn RH, Moseley KE, John N. Community-Based Screening and Treatment for STDs: Results from a Mobile Clinic Initiative THILGES. Centers for Disease Control and Prevention, Atlanta, Georgia; 2003.  Back to cited text no. 19
    
20.
Post P. Mobile Health Care for Homeless People: Using Vehicles to Extend Care. National Health Care for the Homeless Council; May, 2007.  Back to cited text no. 20
    
21.
Vermont. Mobile Screening Clinics. Report to the Legislature on 30 November, 2007. Wermont department of health agency of human services. Available from: http://www.lifelinescreening.com/QUALITY/Pages/HealthScreeningQualityAssurance.aspx.  Back to cited text no. 21
    



 
 
    Tables

  [Table 1]


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