Gibson Britton A, Ghosh Debarchana, Morano Jamie P, Altice Frederick L
Yale University School of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, CT, USA.
University of Connecticut, Department of Geography, Storrs, CT, USA.
Health Place. 2014 Jul;28:153-66. doi: 10.1016/j.healthplace.2014.04.008. Epub 2014 May 21.
We mapped mobile medical clinic (MMC) clients for spatial distribution of their self-reported locations and travel behaviors to better understand health-seeking and utilization patterns of medically vulnerable populations in Connecticut. Contrary to distance decay literature, we found that a small but significant proportion of clients was traveling substantial distances to receive repeat care at the MMC. Of 8404 total clients, 90.2% lived within 5 miles of a MMC site, yet mean utilization was highest (5.3 visits per client) among those living 11-20 miles of MMCs, primarily for those with substance use disorders. Of clients making >20 visits, 15.0% traveled >10 miles, suggesting that a significant minority of clients traveled to MMC sites because of their need-specific healthcare services, which are not only free but available at an acceptable and accommodating environment. The findings of this study contribute to the important research on healthcare utilization among vulnerable population by focusing on broader dimensions of accessibility in a setting where both mobile and fixed healthcare services coexist.
我们绘制了流动医疗诊所(MMC)客户自我报告的地点和出行行为的空间分布图,以更好地了解康涅狄格州医疗弱势群体的就医和利用模式。与距离衰减文献相反,我们发现有一小部分但比例显著的客户会长途跋涉到MMC接受重复治疗。在总共8404名客户中,90.2%居住在距离MMC站点5英里范围内,但在距离MMC 11 - 20英里的人群中,平均利用率最高(每位客户5.3次就诊),主要是患有物质使用障碍的人群。在就诊超过20次的客户中,15.0%的人行程超过10英里,这表明相当一部分少数客户前往MMC站点是因为他们有特定需求的医疗服务,这些服务不仅免费,而且在一个可接受且舒适的环境中提供。本研究的结果通过关注流动和固定医疗服务并存环境中可及性的更广泛维度,为弱势群体医疗利用的重要研究做出了贡献。