Increasing Healthcare Access to At-Risk Populations: Research-based Policies for Mobile Health Clinics

增加高危人群获得医疗服务的机会：基于研究的流动诊所政策项目说明流动诊所在向城市和农村地区的高危人群提供医疗服务方面发挥着重要作用。目前，美国有1500多家流动诊所，每年处理超过500万人次的就诊，提供基本的医疗保健服务。然而，随着时间的推移，这些项目已经有机地发展起来，建立以证据为基础的方法来鼓励这种基本医疗服务模式的系统扩展是很重要的。本提案通过使用流行病学和经济地理信息系统数据，结合专有路由软件来解决这一问题，以实现德克萨斯州休斯顿地区移动诊所医疗保健服务的最佳交付方案。该项目涉及8个不同的提供者，包括设计满足低收入社区未来医疗保健需求的系统战略。其目的还在于开发可在全国范围内由流动诊所项目实施的模式和技术。初步估计表明，该项目可使流动诊所的能力提高20%，从而大大节省医疗费用，并大大改善穷人的生活质量。这些结果符合美国国家科学基金会促进健康进步的使命目标。该项目的总体目标是优化和实施一个基于数据的方案，以协调部署移动诊所方案。我们将首先确定目前八个流动诊所项目的最佳扩展策略，以满足服务不足社区对医疗服务快速增长的需求。然后，该项目将衡量开发的模型和技术的潜力，并将其应用于德克萨斯州其他地区和全国其他州的移动诊所项目。为达致上述目标，小组将首先运用数据挖掘及预测技术，估计选定社区现时及未来的医疗服务需求。我们将把这些方法与先进的GIS制图工具和随机测量相结合，以确定目标人口群。我们还将进行调查和经济分析，以衡量当前移动诊所项目的运营成本和识别运营约束，并为移动诊所服务的部署开发新的优化模型。然后，我们将开发新的有效技术来解决开发的优化模型，以估计当前休斯敦地区移动医疗诊所项目的最大容量，并确定扩展策略，以满足未来的服务需求，同时最小化成本。最后，我们将在基线和干预后评估总体医疗保健成本节约和生活质量对社区水平的影响。

IIS-1637347 Increasing Healthcare Access to At-Risk Populations:Research-based Policies for Mobile Health Clinics Project Description Mobile clinics play an important role in providing healthcare to at-risk populations in both urban and rural areas. Currently, over 1500 mobile clinics operate in the US and handle over 5 million visits per year providing essential healthcare services. These programs, however, have grown organically over time and it is important to establish evidence-based approaches to encourage a systematic expansion of this essential healthcare delivery model. This proposal addresses this issue through the use of epidemiological and economic GIS data, combined with proprietary routing software, to implement a program for optimal delivery of mobile clinic healthcare services in the Houston, Texas, region. The project involves eight different providers and includes designing systematic strategies for meeting future healthcare needs of low-income communities. The aim is also to develop models and techniques that can be implemented by mobile clinic programs throughout the country. Early estimates indicate that this project can result in 20% increase in mobile health clinic capacity, which could translate into significant savings in healthcare costs, and considerable improvements in quality of life for the poor. These results are in line with the NSF mission goal of promoting the advancement of health.The overall goal of this project is to optimize and implement a data-based program for coordinated deployment of mobile clinic programs. We will initially identify optimal expansion strategies for the eight current mobile clinics programs to meet the fast-growing demand for healthcare services in underserved communities. The project will then measure the potential of the developed models and techniques and apply them to mobile clinic programs in other regions of Texas and other states in the nation. To achieve the above goals, the team will first apply data mining and forecasting techniques to estimate present and future demand of healthcare services in selected communities. We will combine these approaches with advance GIS mapping tools and stochastic measures to identify target population clusters. We will also conduct survey and economic analysis to measure the operational cost and identify operational constraints in the present mobile clinic programs, and develop new optimization models for the deployment of the mobile clinic service. Then, we will develop new effective techniques to solve the developed optimization models to estimate the maximum capacity of the current mobile health clinic programs in the Houston region, and identify expansion strategies to meet the future service demand while minimizing cost. Lastly, we will estimate overall healthcare cost savings and quality of life impact at the community level at baseline and post-intervention.