Overcoming Barriers to Access: Taking Health Care Services to Patients
By Molly Miller
The next wave of preventive care is here, and it is manifesting itself in the form of initiatives that take health care directly to patients in an attempt to tear down the barriers to accessing health care services. These initiatives include three main types of clinics: mobile clinics, student-run clinics, and co-located clinics.
Mobile clinics include clinics that provide primary care services, preventive care services, or dental care services from a van, truck, or bus equipped with all of the necessary technology to provide clinical services in underserved areas, both rural and urban. According to Mobile Health Map, over 700 mobile health clinics are currently operating in the United States, with at least one mobile clinic operating in every state.
A 2013 study of a mobile clinic in Boston, known as the “Family Van”, resulted in significant cost savings due to a reduction in emergency room visits as well as a significant reduction in blood pressure among patients who received services from the van.
In Arkansas, Ronald McDonald House Charities partners with the Arkansas Children’s Hospital to operate the Ronald McDonald Care Mobile program, which provides dental care to low-income children across the state through three mobile trucks that deliver care at schools, removing the barrier of parents needing to take time off from work to take their children to the dentist. In addition to providing free, easily accessible dental care to Arkansas children, the Care Mobile also serves as an entry point for the state’s Medicaid program, since students are screened into the program based on their eligibility for the federal Free and Reduced Lunch Program.
Student-run clinics affiliated with medical schools are another unique opportunity for taking medical care where it is needed. These clinics not only provide medical students with experience providing preventive medical care to vulnerable populations, but they are often located in extremely impoverished areas, which provides those individuals with free, easily accessible care. As of 2009, a total of 110 student-run clinics were being operated in the United States.
Despite their usefulness in providing free or low-cost care to needy populations, student-run clinics are limited in the type of care that they are able to provide to patients. For example, student-run clinics can be extremely useful in helping individuals manage chronic diseases such as high blood pressure or diabetes, but they cannot provide more complex care that may be needed by patients with unmanaged chronic diseases, such as surgeries or MRI scans.
Similar to student-run clinics, co-located clinics remove the barriers to accessing health care services by taking care providers directly to needy populations. In fact, some student-run clinics are also co-located clinics that are located in homeless shelters or schools in low-income areas. For example, the University of California – San Diego has four separate student-run clinics, one of which is co-located with Baker Elementary School, allowing both parents and students to access high quality, low-cost health care.
While these three initiatives represent only a small number of programs working to reduce and eliminate barriers to accessing health care services, they offer models that can be duplicated in communities across the United States, regardless of how big or small those communities may be.