Thinking About a Mobile Health Unit to Deliver Services? Things to Consider Before Buying

Abstract

Purchasing a mobile unit to deliver health-care services can be an expensive undertaking for anyone interested in pursuing this option. Yet, little information is found in the literature on planning or designing such vehicles. A set of guidelines could help administrators to make better decisions regarding this approach for delivering healthcare. This article focuses on mobile health units (MHU). It provides a synthesis of the literature in addition to information from written and oral correspondence with the chief executive officers (CEO) of firms that manufacture MHU. On-site visits to agencies using an MHU were made by one of the authors (DM) to glean their perspective. The combined sources led to the development of guidelines and checklists that can assist administrators in planning the function, design and operation of an MHU to deliver health-care services to remote rural sites.

Atenção à saúde de pessoas em situação de rua: estudo comparado de unidades móveis em Portugal, Estados Unidos e Brasil

“…The use of PIH-oriented mobile outreach clinics began in the 1970s. 64 Given the serious situation of PIH in the United States, several social movements pressured the federal government to ensure rights to this public, which led to the establishment of a specific section for PIH in the Anti-Drug Abuse Act 65 . In 1987, under intense pressure from institutions and movements linked to the issue, and from the mobilization of Congressmen Stewart McKinney and Bruce Vento, Congress enacted the McKinney Homeless Assistance Act (later renamed the McKinney-Vento Homeless Assistance Act), which created amendments to the Public Health Service Act for the implementation of PIH services, including outreach strategies 66,67 .…”

“…The existence or not of a vehicle available to the teams seems to be an indicator of the actual capacity to monitor people in their respective territories, since this resource enables transport of professionals along with their equipment and supplies, besides the transfer of patients to other services 19,64 . By omitting the requirement of a car in ERs' proposals, the Portuguese initiative compromises one of the pillars of this strategy, particularly based on the mobility of its team, not contributing to reduced inequity before the difficult access of PIH to services.…”

Utilization of a Mobile Medical Van for Delivering Pediatric Care in the Bateys of the Dominican Republic

“…Factors to consider include the medical and social needs of a targeted population, the provider's resources, and the services that will be offered [8,9]. There are minimal baseline data describing health care availability or disease prevalence, particularly for pediatric patients, in remote communities.…”

O Consultório na Rua e a atenção básica à população em situação de rua

“…Em 2010, 49% dos americanos tinham cobertura de um seguro patrocinado pelo empregador, 17% do Medicaid, 12% do Medicare, com 16% de indivíduos sem qualquer proteção social em saúde (Noronha, et al, 2014) O uso de clínicas móveis de busca ativa (mobile out reach clinics) dirigidas às PSRs teve início nos anos 1970 por iniciativas de governos municipais (Moulavi, et al, 2000). Dada a gravidade da situação das PSRs nos EUA, diversos movimentos sociais pressionaram o governo federal a garantir direitos a esse público, o que levou à criação de uma seção específica para a população de rua na Lei Antiabuso de Drogas Com o advento da Constituição de 1988, a saúde passou a ser um direito de cidadania no Brasil, assegurado através do SUS (Bahia, 2005), cujo objetivo é oferecer uma cobertura universal, integral e equitativa por meio de redes organizadas de serviços, sob gestão compartilhada entre a esfera federal, estadual e municipal do governo (Brasil, 1988a).…”

“…A existência ou não de um automóvel à disposição das equipes nos parece um indicador da efetiva capacidade de acompanhar as pessoas em seus respectivos territórios, uma vez que tal recurso permite o deslocamento dos profissionais e a condução de equipamentos e insumos, além do translado dos pacientes para outros serviços (Moulavi, et al, 2000;Hallais, et al, 2015). Ao omitir a exigência de um automóvel nas propostas relativas às ERs, a iniciativa portuguesa compromete um dos pilares dessa estratégia, pautada justamente na mobilidade de sua equipe, não contribuindo para a redução da iniquidade diante das dificuldades das PSRs em acessarem os serviços.…”