PICO Statement Latinos in America

Latinos in America are both at risk and underserved and, as another minority group, face a myriad of problems, in particular disparities in quality healthcare. Because of health disparity in the United States, Hispanics have to grapple with nonfinancial and financial barriers to access quality health care. Immigration status, language, and acculturation directly influence access to health care. The language barrier implies that the affected Hispanics will have difficulties in seeking and obtaining health care, as well as benefiting from healthcare information published in the media. Recent immigrants in the United States are likely to be left out from the mainstream United States, as well as being unfamiliar with the health care system in the country (Colas & Arroyo, 2010). It is for this reason that this study seeks to evaluate whether Latinos in low socioeconomic communities will register decreased hospital admission rates when a mobile clinic is deployed as a form of helping to improve access to primary care compared to the current status quo.

A notable barrier to access to quality care is the lack of money. First, the lack of having an active health insurance cover and the lack of consistent source care contribute to health disparity in Hispanics. In this manner, health insurance is one of the primary predictors of utilization of health care services both for an individual and for a group of individuals. For some, it means having to decide between placing the next meal on the table and paying for healthcare costs. This is despite the fact that the American healthcare system is the most expensive but ranks poorly when compared to that of other developed nations (Colas & Arroyo, 2010). The implication is that having a source of income will give a locus of entry into the advanced health care delivery system for an individual. With this in mind, it is essential to ascertain the admission rates of Latinos in low socioeconomic communities after introducing a mobile clinic meant to enhance access to primary care considering the current state of affairs.

Intervention

Notably, the intervention has to acknowledge several aspects of the target population. First, there are increased heart failure readmission rates among the Hispanic population that is not yet insured in the St. Louis’ metro-east area. The barriers identified need to be addressed to ensure the access to quality care for the uninsured Latinos in the low socio-economic communities is achieved (Colas & Arroyo, 2010). Thus, the proposed approach is to have a mobile clinic offering health awareness and healthcare services that take into account identified challenges such as language barrier and acculturation. For instance, having a mobile clinic within the neighborhood should help make the interested members of the community comfortable with seeking medical services, as they should feel welcome. Thus, the intervention is to deploy a mobile clinic that incorporates the concerns and challenges faced by a minority community in offering health care services.

Similarly, community engagement and collaboration should help build a trusting relationship. For a start, the staffing of the mobile clinic should include staff that is culturally competent, welcoming, and non-judgmental among other attributes and skills. Through this, this mobile clinic will make a partnership with community services, food pantries, health clinics, and churches to obtain referrals for patients with critical health care needs. The other reason for having this kind of approach and arrangement is that the mobile clinic will park at strategic community places such as churches and shopping centers and it is essential to create anticipation and acceptance within members of the community (Colas & Arroyo, 2010). Strange as it sounds, some members of minority communities with questionable immigrant status are reluctant to seek healthcare services for fear of exposing their illegal status to the authorities. Local leaders and community figures will play a critical role in helping rally the community to drop phobias and reservations and embrace the services offered by the mobile clinic.

Comparison

In other cities, such as those in Illinois, mobile clinics are providing care for 10 to 25 patients in a day at strategic locations, such as near community centers. Cumulatively, these mobile clinic patient visits are 3, 300 in a year according to Champaign-Urbana Public Health District (2017). As Champaign-Urbana Public Health District (2017) indicates, the mobile clinics in Illinois have helped place at least 400 Hispanics into the Medicaid program in a twelve-month period. The overall aim is to link these newly insured patients with a primary provider at any of the Southern Illinois Health Care Foundation, which is in the St. Louis area and provides culturally sensitive bilingual staff.

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Another important point is that the focus on HF is not accidental as among Hispanics residing in the United States, HF is a primary cause of death, gender, and home country notwithstanding. The other reason for focus is that despite all odds, the Latinos are the fastest-growing population segment in the United States (Velasco-Mondragon, Jimenez, Palladino-Davis, Davis, & Escamilla-Cejudo, 2016). The implication is that all factors constant, HF will have a wider adverse impact on the healthcare system in the United States (Doyle, 2012). Finding innovative approaches to address these shortcomings will contribute to easing pressure on the health care system in the midterm and long-term future. Fortunately, HF can be tackled before it becomes a fatal condition by conducting routine medical checks and mobile clinics are effective for minority population communities in supplementing mainstream medical care.

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Outcome

In particular, there are several expectations from this intervention. By avoiding unnecessary mainstream hospital visits for a population that has challenges having a stable source of income, the mobile clinic will save money that can be used in proper nutrition thus reinforcing the health of the target community. Secondly, by having a large number of the community embrace health awareness and medical checkups as well as early interventions, the mobile clinic will contribute to decreasing expensive emergency department visits and lower HF from at least 27% to 19% according to Velasco-Mondragon et al. (2016). All of this is possible by providing preventative screenings and follow-up discharge visits.

In particular, patients in need of additional treatment or diagnostic services will get referrals to community health centers, local providers, or primary care providers. For emphasis, mobile health clinics can generate significant cost savings. In fact, for every dollar spent on operating a mobile health clinic, there shall be a return of 4 to 40 dollars due to the services it provides as per the Mobile Health Clinic Networks (Lynch, 2011). The network has over 300 organizations and calculates the return on investment among other duties (Lynch, 2011).

Lastly, the deployment of mobile clinics is in line with the fulfilling implementation of the Affordable Care Act. The running of the mobile clinic will contribute to enhanced access to health care for Hispanics and partially address the challenges cited. The challenges include health literacy, cultural sensitivity, and the shortage of Hispanic providers. The mobile clinic intervention, however, cannot solve the issue of the immigration status of affected Latinos even though this directly affects their ability to access healthcare (Velasco-Mondragon et al., 2016). By taking all factors into account, the intervention will contribute to increased healthcare awareness, better understanding of Latinos from the cultural point of view, and highlight other underlying issues via advocacy of participating nurses.