-
Frontiers in Public Health 2022The mobile emergency system is a new emergency mode that provides a solution to deal with increasingly frequent sudden disasters by reasonably allocating mobile...
The mobile emergency system is a new emergency mode that provides a solution to deal with increasingly frequent sudden disasters by reasonably allocating mobile emergency facilities and optimizing the allocation of mobile emergency materials. We consider mobile emergency cost and mobile emergency time as two objective functions. This paper establishes a multi-objective mobile emergency material allocation model, and transforms the multi-objective. We choose the emergency material transportation path for coding, and apply the hybrid leapfrog algorithm for material allocation to obtain the optimal solution. Finally, the feasibility of the model is verified by taking Zhengzhou urban area under the "21.7" severe rainstorm and flood disaster in Henan Province. The result analyses show that the model can correspond to each stage of mobile emergency material allocation based on the value of cost preference, and put forward suggestions on the location of mobile emergency facilities and the amount of material allocation.
Topics: Algorithms; Disasters; Emergencies; Emergency Medical Services; Mobile Health Units
PubMed: 35910880
DOI: 10.3389/fpubh.2022.927241 -
Lancet (London, England) Apr 2020
Topics: Betacoronavirus; COVID-19; China; Coronavirus Infections; Emergencies; Hospitals, Special; Humans; Mobile Health Units; Pandemics; Pneumonia, Viral; Public Health; SARS-CoV-2
PubMed: 32305082
DOI: 10.1016/S0140-6736(20)30864-3 -
Anaesthesia, Critical Care & Pain... Jun 2020
Topics: Aircraft; Betacoronavirus; COVID-19; Coronavirus Infections; Emergency Medical Dispatch; Emergency Medical Service Communication Systems; France; Humans; Intensive Care Units; Military Health Services; Mobile Health Units; Pandemics; Patient Care Team; Pneumonia, Viral; Respiratory Distress Syndrome; Respiratory Therapy; SARS-CoV-2; Time Factors; Transportation of Patients
PubMed: 32423608
DOI: 10.1016/j.accpm.2020.05.002 -
International Journal For Equity in... Apr 2022Access to professional health care providers in Loja Province, Ecuador can be difficult for many citizens. The Health Care Access Barrier Model (HCAB) was established to...
BACKGROUND
Access to professional health care providers in Loja Province, Ecuador can be difficult for many citizens. The Health Care Access Barrier Model (HCAB) was established to provide a framework for classification, analysis, and reporting of modifiable health care access barriers. This study uses the HCAB Model to identify barriers and themes impacting access to health care access in southern rural Ecuador.
METHODS
The research team interviewed 22 participants and completed 15 participant observation studies in the study area. Interviews and a single focus group session of artisans were recorded and transcribed from Spanish to English, and thematic analysis was performed.
RESULTS
The thematic analysis found financial, structural, and cognitive health care access barriers. Cost of medications, transportation, missed responsibilities at work and home, difficulty scheduling appointments, and misconceptions in health literacy were the predominant themes contributing to health care access. These pressure points provide insight on where actions may be taken to alleviate access barriers.
CONCLUSION
Modifiable health care access barriers outlined in the HCAB are evident in the study area. Further research and implementation of programs to resolve these barriers, such as the creation of health care subcenters and/or mobile clinic, insurance coverage of specialized care, increasing availability and accessibility to affordable transportation, improving roadways, introduction of a 24/7 call center to schedule medical visits, monetary incentive for primary care physicians to practice in rural and underserved areas, provision of affordable work equipment, and emphasizing the improvement of health care literacy through education, may diminish current barriers, identify additional barriers, and improve overall health in the rural area of Loja, Ecuador and similar rural regions around the world.
Topics: Ecuador; Focus Groups; Health Services Accessibility; Humans; Mobile Health Units; Rural Population
PubMed: 35459253
DOI: 10.1186/s12939-022-01660-1 -
Disaster Medicine and Public Health... Jun 2020Disasters such as an earthquake, a flood, and an epidemic usually lead to large numbers of casualties accompanied by disruption of the functioning of local medical...
Disasters such as an earthquake, a flood, and an epidemic usually lead to large numbers of casualties accompanied by disruption of the functioning of local medical institutions. A rapid response of medical assistance and support is required. Mobile hospitals have been deployed by national and international organizations at disaster situations in the past decades, which play an important role in saving casualties and alleviating the shortage of medical resources. In this paper, we briefly introduce the types and characteristics of mobile hospitals used by medical teams in disaster rescue, including the aspects of structural form, organizational form, and mobile transportation. We also review the practices of mobile hospitals in disaster response and summarize the problems and needs of mobile hospitals in disaster rescue. Finally, we propose the development direction of mobile hospitals, especially on the development of intelligence, rapid deployment capabilities, and modularization, which provide suggestions for further research and development of mobile hospitals in the future.
Topics: Civil Defense; Disasters; Humans; Mobile Health Units
PubMed: 32317031
DOI: 10.1017/dmp.2020.113 -
Value in Health : the Journal of the... Oct 2019Breast cancer is the leading cancer in terms of incidence and mortality among women in France. Effective organized screening does exist, however, the participation rate...
BACKGROUND
Breast cancer is the leading cancer in terms of incidence and mortality among women in France. Effective organized screening does exist, however, the participation rate is low, and negatively associated with a low socioeconomic status and remoteness.
OBJECTIVES
To determine the cost-effectiveness of a mobile mammography (MM) program to increase participation in breast cancer screening and reduce geographic and social inequalities.
METHODS
A cost-effectiveness analysis from retrospective data was conducted from the payer perspective, comparing an invitation to a mobile mammography unit (MMU) or to a radiologist's office (MM or RO group) with an invitation to a radiologist's office only (RO group) (n = 37 461). Medical and nonmedical direct costs were estimated. Outcome was screening participation. The mean incremental cost and effect, the incremental cost-effectiveness ratio, and the cost-effectiveness acceptability curve were estimated.
RESULTS
The mean incremental cost for invitation to MM or RO was estimated to be €23.21 (95% CI, 22.64-23.78) compared with RO only, and with a point of participation gain of 3.8% (95% CI, 2.8-4.8), resulting in an incremental cost per additional screen of €610.69 (95% CI, 492.11-821.01). The gain of participation was more important in women living in deprived areas and for distances exceeding 15 km from an RO.
CONCLUSION
Screening involving a MMU can increase participation in breast cancer screening and reduce geographic and social inequalities while being more cost-effective in remote areas and in deprived areas. Because of the retrospective design, further research is needed to provide more evidence of the effectiveness and cost-effectiveness of using a MMU for organized breast cancer screening and to determine the optimal conditions for implementing it.
Topics: Aged; Breast Neoplasms; Cost-Benefit Analysis; Early Detection of Cancer; Female; France; Healthcare Disparities; Humans; Mammography; Middle Aged; Mobile Health Units
PubMed: 31563253
DOI: 10.1016/j.jval.2019.06.001 -
Disaster Medicine and Public Health... Jun 2022The coronavirus disease (COVID-19) pandemic represented an unprecedented challenge for health care facilities, and innovative solutions were urgently required to...
The coronavirus disease (COVID-19) pandemic represented an unprecedented challenge for health care facilities, and innovative solutions were urgently required to overcome the high volume of critically ill infectious patients, limit in-hospital outbreaks, and limit the risk of occupational infection for health care workers (HCWs). Bergamo was the hardest-hit Italian province by COVID-19, and the local health care system had to undergo a profound and prompt reorganization. A COVID-19-only field hospital was rapidly set up meeting the standards for severe acute respiratory infection (SARI) treatment centers (https://apps.who.int/iris/handle/10665/331603). A zones partition, dedicated in-hospital pathways for HCWs, strict infection prevention and control (IPC) measures, and constant staff supervision were key components of our strategy to limit the risk of occupational infection for HCWs. Herein, we present the Bergamo field hospital layout enlightening fundamental IPC measures adopted as a valuable example of a SARI treatment center confronting COVID-19.
Topics: Humans; COVID-19; Mobile Health Units; SARS-CoV-2; Pandemics; Health Personnel
PubMed: 33208198
DOI: 10.1017/dmp.2020.447 -
Stroke May 2020Background and Purpose- Endovascular thrombectomy (ET) door-to-puncture time (DTPT) is a modifiable metric. One of the most important, yet time-consuming steps, is...
Background and Purpose- Endovascular thrombectomy (ET) door-to-puncture time (DTPT) is a modifiable metric. One of the most important, yet time-consuming steps, is documentation of large vessel occlusion by computed tomography angiography (CTA). We hypothesized that obtaining CTA on board a Mobile Stroke Unit and direct alert of the ET team shortens DTPT by over 30 minutes. Methods- We compared DTPT between patients having CTA onboard the Mobile Stroke Unit then subsequent ET from September 2018 to November 2019 and patients in Mobile Stroke Unit from August 2014 to August 2018, when onboard CTA was not yet being used. We also correlated DTPT with change in National Institutes of Health Stroke Scale between baseline and 24 hours. Results- Median DTPT was 53.5 (95% CI, 35-67) minutes shorter with onboard CTA and direct ET team notification: 41 minutes (interquartile range, 30.0-63.5) versus 94.5 minutes (interquartile range, 69.8-117.3; <0.001). Median on-scene time was 31.5 minutes (interquartile range, 28.8-35.5) versus 27.0 minutes (interquartile range, 23.0-31.0) (<0.001). Shorter DTPT correlated with greater improvement of National Institutes of Health Stroke Scale (correlation=-0.2, =0.07). Conclusions- Prehospital Mobile Stroke Unit management including on-board CTA and ET team alert substantially shortens DTPT. Registration- URL: https://clinicaltrials.gov; Unique identifier: NCT02190500.
Topics: Aged; Aged, 80 and over; Computed Tomography Angiography; Emergency Medical Services; Endovascular Procedures; Female; Humans; Male; Middle Aged; Mobile Health Units; Stroke; Thrombectomy; Thrombolytic Therapy; Time-to-Treatment
PubMed: 32295510
DOI: 10.1161/STROKEAHA.119.028626 -
Journal of Special Operations Medicine... 2010
Topics: Humans; Military Medicine; Mobile Health Units; Ultrasonography; United States
PubMed: 20306420
DOI: No ID Found -
International Journal For Equity in... May 2020Mobile Clinics represent an untapped resource for our healthcare system. The COVID-19 pandemic has exacerbated its limitations. Mobile health clinic programs in the US...
BACKGROUND
Mobile Clinics represent an untapped resource for our healthcare system. The COVID-19 pandemic has exacerbated its limitations. Mobile health clinic programs in the US already play important, albeit under-appreciated roles in the healthcare system. They provide access to healthcare especially for displaced or isolated individuals; they offer versatility in the setting of a damaged or inadequate healthcare infrastructure; and, as a longstanding community-based service delivery model, they fill gaps in the healthcare safety-net, reaching social-economically underserved populations in both urban and rural areas. Despite an increasing body of evidence of the unique value of this highly adaptable model of care, mobile clinics are not widely supported. This has resulted in a missed opportunity to deploy mobile clinics during national emergencies such as the COVID-19 pandemic, as well as using these already existing, and trusted programs to overcome barriers to access that are experienced by under-resourced communities.
MAIN TEXT
In March, the Mobile Healthcare Association and Mobile Health Map, a program of Harvard Medical School's Family Van, hosted a webinar of over 300 mobile health providers, sharing their experiences, challenges and best practices of responding to COVID 19. They demonstrated the untapped potential of this sector of the healthcare system in responding to healthcare crises. A Call to Action: The flexibility and adaptability of mobile clinics make them ideal partners in responding to pandemics, such as COVID-19. In this commentary we propose three approaches to support further expansion and integration of mobile health clinics into the healthcare system: First, demonstrate the economic contribution of mobile clinics to the healthcare system. Second, expand the number of mobile clinic programs and integrate them into the healthcare infrastructure and emergency preparedness. Third, expand their use of technology to facilitate this integration.
CONCLUSIONS
Understanding the economic and social impact that mobile clinics are having in our communities should provide the evidence to justify policies that will enable expansion and optimal integration of mobile clinics into our healthcare delivery system, and help us address current and future health crises.
Topics: COVID-19; Coronavirus Infections; Diffusion of Innovation; Health Policy; Humans; Mobile Health Units; Models, Organizational; Pandemics; Pneumonia, Viral; United States
PubMed: 32429920
DOI: 10.1186/s12939-020-01175-7