Mobile health clinics in the United States.

Background: Mobile health clinics serve an important role in the health care system, providing care to some of the most vulnerable populations. Mobile Health Map is the only comprehensive database of mobile clinics in the United States. Members of this collaborative research network and learning community supply information about their location, services, target populations, and costs.

Meal Delivery Programs Reduce The Use Of Costly Health Care In Dually Eligible Medicare And Medicaid Beneficiaries.

Delivering food to nutritionally vulnerable patients is important for addressing these patients' social determinants of health. However, it is not known whether food delivery programs can reduce the use of costly health services and decrease medical spending among these patients. We sought to determine whether home delivery of either medically tailored meals or nontailored food reduces the use of selected health care services and medical spending in a sample of adults dually eligible for Medicare and Medicaid.

Preventative health, diversity, and inclusion: a qualitative study of client experience aboard a mobile health clinic in Boston, Massachusetts.

Background: There are approximately 2000 mobile health clinics operating in the United States. While researchers have established that mobile health clinics can be cost effective and improve outcomes, there is scant research examining the healthcare experience on a mobile health clinic from patients' perspectives.

Methods: Data were gathered from interviews with 25 clients receiving care on a Boston-based mobile health clinic and analyzed using grounded theory methodology.

The scope and impact of mobile health clinics in the United States: a literature review.

As the U.S. healthcare system transforms its care delivery model to increase healthcare accessibility and improve health outcomes, it is undergoing changes in the context of ever-increasing chronic disease burdens and healthcare costs.

The Emerging Business Models and Value Proposition of Mobile Health Clinics.

Mobile health clinics are increasingly used to deliver healthcare to urban and rural populations. An estimated 2000 vehicles in the United States are now delivering between 5 and 6 million visits annually; however, despite this growth, mobile health clinics represent an underutilized resource that could transform the way healthcare is delivered, especially in underserved areas. Preliminary research has shown that mobile health clinics have the potential to reduce costs and improve health outcomes.

Outcomes of Oral Health Screenings at Two Different Institutions Serving Individuals with Special Health Care Needs in Massachusetts.

Background: As part of the 2009-2010 Massachusetts Dental Society Leadership Institute, two oral health screening and prevention education programs were conducted at institutions in Massachusetts that serve individuals with special health care needs (ISHCN).

Methods: Members of the Leadership Institute class of 2009-2010 built relationships with two institutions that served individuals with ISHCN-one that housed residents with special health care needs and another that served as a day-care facility. Oral health screenings were conducted at both institutions.

Mobile health clinics in the era of reform.

Objectives: Despite the role of mobile clinics in delivering care to the full spectrum of at-risk populations, the collective impact of mobile clinics has never been assessed. This study characterizes the scope of the mobile clinic sector and its impact on access, costs, and quality. It explores the role of mobile clinics in the era of delivery reform and expanded insurance coverage.

Mobile clinic in Massachusetts associated with cost savings from lowering blood pressure and emergency department use.

Mobile health clinics are in increasingly wide use, but evidence of their clinical impact or cost-effectiveness is limited. Using a unique data set of 5,900 patients who made a total of 10,509 visits in 2010-12 to the Family Van, an urban mobile health clinic in Massachusetts, we examined the effect of screenings and counseling provided by the clinic on blood pressure. Patients who presented with high blood pressure during their initial visit experienced average reductions of 10.

Knowledgeable Neighbors: a mobile clinic model for disease prevention and screening in underserved communities.

The Family Van mobile health clinic uses a "Knowledgeable Neighbor" model to deliver cost-effective screening and prevention activities in underserved neighborhoods in Boston, MA. We have described the Knowledgeable Neighbor model and used operational data collected from 2006 to 2009 to evaluate the service. The Family Van successfully reached mainly minority low-income men and women.

The effect of operative timing on functional outcome after isolated spinal trauma.

Background: To evaluate the effect of operative timing on functional outcome in patients suffering spinal trauma, we conducted a retrospective analysis of the National Trauma Data Bank. By treating time to operation as a categorical variable and limiting our analysis to isolated spinal trauma, we hypothesized that time to operation would not be a predictor of functional outcome.

Methods: The National Trauma Data Bank was queried for all patients with isolated spinal trauma who underwent spinal fixation or decompression.

Insurance status and hospital discharge disposition after trauma: inequities in access to postacute care.

Background: Postacute care is an essential component of medical care aimed at returning trauma patients to their preinjury functional status. Rehabilitation services, skilled nursing facilities, and home care all play a role in facilitating the healing process. Access to such care may be limited based on insurance status, leaving the uninsured with limited resources to reach full recovery.

Insights into the rise in HIV infections, 2001 to 2008: a Bayesian synthesis of prevalence evidence.

Objective: To estimate trends in prevalence of HIV infection, undiagnosed and total, among adults aged 15-44 years in England and Wales since 2001.

Design: Multiple surveillance systems and survey data are available to inform different aspects of the HIV epidemic in England and Wales. To coherently and consistently combine this information to estimate trends in HIV prevalence, we apply a multiparameter evidence synthesis in a Bayesian statistical framework.

Monitoring the emergence of community transmission of influenza A/H1N1 2009 in England: a cross sectional opportunistic survey of self sampled telephone callers to NHS Direct.

Objective: To evaluate ascertainment of the onset of community transmission of influenza A/H1N1 2009 (swine flu) in England during the earliest phase of the epidemic through comparing data from two surveillance systems.

Design: Cross sectional opportunistic survey.

Study Samples: Results from self samples by consenting patients who had called the NHS Direct telephone health line with cold or flu symptoms, or both, and results from Health Protection Agency (HPA) regional microbiology laboratories on patients tested according to the clinical algorithm for the management of suspected cases of swine flu.

Coming home to die? The association between migration and mortality in rural South Africa.

Background: Studies on migration often ignore the health and social impact of migrants returning to their rural communities. Several studies have shown migrants to be particularly susceptible to HIV infection. This paper investigates whether migrants to rural households have a higher risk of dying, especially from HIV, than non-migrants.

Refining the criteria for stalled fertility declines: an application to rural KwaZulu-Natal, South Africa, 1990-2005.

Stalled fertility declines have been identified in several regions across the developing world, but the current conceptualization of a stalled fertility decline is poorly theorized and does not lend itself to objective measurement. We propose a more rigorous and statistically testable definition of stalled fertility decline that can be applied to time-series data. We then illustrate the utility of our definition through its application to data from rural South Africa for the period 1990-2005 collected from a demographic surveillance site.

The effects of high HIV prevalence on orphanhood and living arrangements of children in Malawi, Tanzania, and South Africa.

Using longitudinal data from three demographic surveillance systems (DSS) and a retrospective cohort study, we estimate levels and trends in the prevalence and incidence of orphanhood in South Africa, Tanzania, and Malawi in the period 1988-2004. The prevalence of maternal, paternal, and double orphans rose in all three populations. In South Africa - where the HIV epidemic started later, has been very severe, and has not yet stabilized - the incidence of orphanhood among children is double that of the other populations.

Population and antenatal-based HIV prevalence estimates in a high contracepting female population in rural South Africa.

Background: To present and compare population-based and antenatal-care (ANC) sentinel surveillance HIV prevalence estimates among women in a rural South African population where both provision of ANC services and family planning is prevalent and fertility is declining. With a need, in such settings, to understand how to appropriately adjust ANC sentinel surveillance estimates to represent HIV prevalence in general populations, and with evidence of possible biases inherent to both surveillance systems, we explore differences between the two systems. There is particular emphasis on unrepresentative selection of ANC clinics and unrepresentative testing in the population.