Study: Mobile Clinic Saves Money, Improves Health For Low-Income Patients

The Boston “Family Van” is an urban mobile health clinic that travels to some of the city’s poorest, medically underserved communities — Dorchester, Roxbury, East Boston, Hyde Park and Mattapan — caring for patients who have the highest rates of preventable illness, hospitalizations and avoidable emergency department visits. (Not surprisingly, these are also some of the neighborhoods hardest hit by the current flu epidemic.)

A program of Harvard Medical School, The Van is staffed by community health workers, and sometimes by doctors and nurses. Their goal is to bring medical care to the people rather than wait for the people to seek care (which may or may not happen, and if it does, may be dangerously delayed).

A patient treated by staff at Boston's Family Van

A patient, Geralyn Lynch, treated by staff at Boston’s Family Van in Dorchester, Mass. (Photo: Mim Adkins)

A recent study, published in the journal Health Affairs, found that the Family Van — with its neighborhood version of house calls — also saves money by preventing ER visits. Additionally, patients receiving care from The Van staff were able to reduce their blood pressure, researchers report.

The study, by researchers at Harvard Medical School, looked at data from 5,900 patients who made a total of 10,509 visits between 2010 and 2012.

Here’s more from the paper:

“The average reductions in systolic and diastolic blood pressure were associated with a 31.0 percent and a 33.3 percent reduction, respectively, in the relative risk of myocardial infarction. Similarly, the blood pressure reductions were associated with a 40.4 percent and a 48.8 percent reduction, respectively, in the relative risk of stroke. Following the literature, we averaged the systolic and diastolic effects to arrive at an overall relative risk reduction of 32.2 percent in myocardial infarction and 44.6 percent in stroke associated with the blood pressure reductions…

In a population ages 55–64 that is evenly divided among men and women, the incidence of myocardial infarction is estimated to be about 11.4 per 1,000 person-years, and the incidence of stroke about 3.3 per 1,000 person-years. Using average attributable costs per case, the reductions in incidence were estimated to have saved $235,254 from blood pressure reductions over the thirty-six-month study period.

With each avoidable emergency department visit costing on average $474 in Massachusetts, we estimated total savings of about $1.4 million from the 2,851 reported emergency department visits avoided. These savings were much larger than the savings from blood pressure reduction. Thus, estimated savings from the use of mobile clinics were driven by the number of emergency department visits avoided.

Total mobile clinic savings were about $1.6 million from January 2010 through June 2012. Total operating expenditures during the same period were $1,222,886. Operating expenses included personnel salaries and benefits, vehicle operations and utilities costs, and mobile clinic administrative costs. The ratio of total savings to total expenditures, or return on investment, was thus 1.3.”

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  • dyerkutn

    My father knew that this would work 50 years ago when he experimented with mobile clinics in the Bronx as part of his work at Albert Einstein College of Medicine.

  • EB VT

    This is amazing! It is innovators like the people of the Family Van that will change the way healthcare is delivered! This is the perfect way to bring the needed care to areas where people might not have adequate access. Soon we will see these all over the US and world!

  • Krista Conley

    This is fantastic – what outcomes! We always see folks looking to big companies for health care solutions, but here is a case where a smart ground game and smarter leadership can pave the way – literally!

  • Reasonable?

    This is a Napster moment for health care.

    You can take a van with some simple supplies and trained community health workers and make a significatn health care impact.

    But instead we are building a big expensive infrastructure to do the same job.