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Developing a Business Case

School of Nursing and Health Sciences, Capella University

NHS- FPX6008: Economics and Decision Making in Health Care

Nicole Aclin

July, 2021
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Potential Economic Opportunities and Risks of a Mobile Health Clinic

Karen Medical Centre is at the center of a busy metropolitan serving multiple

communities and visitors. In most cases, the medical center operates at a full capacity providing

both inpatient and outpatient care. The proposal of having a mobile clinic aims to serve the

population that is often in low access to health care as well as to reduce the number of

outpatients at the Medical Centre. This is mainly to allow the medical center an optimal

performance without straining its current capacity.

The potential economic opportunities linked to a mobile health clinic vary by degree of

use and capacity. The Karen Medical Centre mobile health clinic aims to provide preventive

health which is a significant contribution to the general goal of health through offering quality

and affordable health care to all communities without biases of race, gender, ethnicity, religious

or cultural background. Mobile health clinics aim to make health care accessible and this is

essential especially in a season where the access and capacity of health care facilities have been

highly challenged by the ongoing pandemic Covid-19. First, the mobile health clinics work to

ensure that the rate of infections and contaminations are reduced in such and similar cases where

patients are spared from having to commute for long distances in search of healthcare (Brown-

Connolly, Concha, & English, 2014). By availing the mobile health clinic in communities and

neighborhoods, the Karen Medical Centre increases its value and relationship with the

community. This can be considered as a potential benefit in that patients will not go looking for

other health care facilities for their health care needs and will instead opt to utilize the resources

and care provided by the medical centers. The advantage of mobile health clinics is that they

help in promoting awareness which creates healthier communities. Secondly, having a mobile
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health clinic increases the utilization of staff in the hospital without breaking the budget. With

the availability of a mobile health unit, the nurses and trainee nurses have access to a diverse

pool of experience which is a great contribution to workforce diversity. An article by Health

Research & Educational Trust (2015) established that mobile health clinics equip the human

resources working in them with diverse experiences that come from dealing with patients from

different walks of life. Similarly, diversity promotes inclusion where mobile health clinics

support employee participation in community events creating a foundation of trust and

confidence (Bouchelle, 2017).

In line with the potential benefits of mobile health clinics, there are several potential

risks. These may include the lack of adequate evidence of the feasibility of the mobile health

clinics especially in cases where the capacity is in the challenge (Abbasi, Mohajer & Samouei,

2016). For instance, most mobile health clinics are only equipped to handle a certain level of

illnesses and this may exclude the patients in need to advance medical attention, like patients

living with disabilities or those in need of ECG machines who could be the majority in the

community. In such a case, the mobile health clinic may not meet its obligation posing a

financial risk to the main health organization. Similarly, the community could reject the services

offered by the mobile health clinic causing a financial risk to the main organization arising from

the already purchased equipment and medication (Abasi et al., 2016). The unwillingness of the

community to utilize the mobile health clinic is a financial threat to the health care organization,

especially where donor funding/grants are involved since the health care is expected to provide

accountability of this funding. In cases where there is not sufficient evidence of the use of the

funding, the health care organization may in the future struggle to attain any funding which is

detrimental to the financial security (Malone, 2020).

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In comparing the potential opportunities to the potential risks, the opportunities still

outweigh the risks and they have a full backing of the community health and wellbeing. For

instance, having a mobile health clinic providing access to patients in low social and economic

environments outweighs the chances of that community rejecting health care and contributes to

both the social and health wellness of the community and the state in general. Additionally,

having a mobile health clinic that avails timely health care reduces the strain on the capacity of

the larger medical Centre by reducing in-patients and patient wait time which promotes the

efficiency and effectiveness of the medical Centre. Therefore, a close analysis indicates that the

economic benefits and the medical benefits far outweigh the risks associated with the mobile

health clinic and these risks have a probable mitigation strategy.

Ethical And Culturally Sensitive Solutions

Effective mobile health clinics ought to have stable relationships with the community

they serve, for this to happen the community needs to feel understood and protected by the health

care professionals. One way to ensure this happens is by establishing a culturally aware and

competent workforce. Stephanie et al., (2017) explain that the success of the majority of mobile

health clinics is based on trust between the health care-client relationship. Whereby, the

community believes in the systems and in the staff members who are easy to talk to and those

who empathize with the community. The Mobile health clinic's main goal is to reach the patient

at their level and this seeks to follow a patient-centric model which is impossible to achieve

without a culturally aware and competent workforce.

Ethical guidelines further play an essential role in supporting the mobile health clinic as

this provides the platform in which the health care professionals conduct their role competently.
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The ethical principles of autonomy, beneficence, non-maleficence, and justice guide the

operations and relationships of the mobile health clinic. The ethical principles are essential

especially in this case since the patients are vulnerable or from the minority which could hinder

the application of standard health care policies. However, the full awareness and willingness to

apply them in administering health care promotes equality and reduces the health inequality

margins noted in the state and the country.

Costs and Benefits Analysis

The cost-benefit analysis provides the service for the three categories that include the

dental/dental preventive, preventive care, and primary, preventive care where costs are estimated

in aggregate. According to Attipoe-Dorcoo et al., (2020), the cost of mobile health clinics is

largely affected by the number of patients, staff and distance traveled to access the patients. The

specific targets make it difficult to develop a static cost and benefit analysis. However, based on

the previous population trends, availability of full-time and part-time staff as well as the

estimated regions, the proposed initiative has placed an approximate budget. The analysis also

adds other factors that are hard to estimate in regards to their nature, for instance, it is difficult to

identify the health status of the population over a specific period and thus difficult to know the

kind of care needed (Attipoe-Dorcoo et al., 2020). The growth/increase in the budget cost arises

from these factors that are difficult to estimate over time and this provides a buffer from intense

losses or chances of shutting the mobile clinic in case circumstances change. It is therefore

important for the organization to put into consideration the cost and benefit analysis as proposed.

Equitable Ethical and Cultural Practices

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Mobile health clinics must maintain ethical standards and observe health care guidelines

to reduce costs that are likely to arise through poor practices. For instance, the ethical principles

advocate for autonomy whereby the health care professional is mandated by oath to allow the

patient to decide following full access to the information regarding their health. This means that

health care professionals ought to share all the information with their patients including the

treatment options available without bias of their social-economic status (Kirsch, Long & Schmid,

n.d).

Similarly, the principle of non-maleficence states that no harm should be done to patients,

and this is especially critical in reducing medication administration errors in mobile health

clinics. By adhering to such principles, the health care professionals avoid lawsuits or losses that

are likely to arise from a bad reputation in the community. It is therefore necessary to offer

comprehensive training to the health care professionals working in the mobile health clinic in

order to fully sensitize them to the dynamics of their operations away from the main medical

Centre (Stephanie et al., 2017). It is also necessary to have senior nurses and doctors conduct

routine rounds with the mobile health clinic nurses and staff members to ensure adherence to the

protocol during health care administration. Routine reporting and internal audits are other

strategies likely to reduce additional costs and increase the efficiency of the mobile clinic

(Taylor, 2015).

Significance of the Scholarly Evidence

The concept of mobile health clinics is still new and not fully explored, however,

numerous researches have been carried in the areas based on the operational mobile health

clinics across various states in the US and across the world. The effectiveness of Mobile health
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clinics is especially significant in regions with high populations of people living below the

federal poverty level and regions with little to no access to healthcare. The scholarly evidence

stipulated throughout the proposal supports the relevance of the mobile health clinic not only in

the USA but across the world. The evidence is timely and research is within the last 10years

presenting timely findings and drawing relevant conclusions. The scholarly evidence further

indicates the possibility and the success of running mobile health clinics and provides the facts

that support the successful running of the Mobile health clinic.

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References

Abbasi, S., Mohajer, H., & Samouei, R. (2016). Investigation of mobile clinics and their

challenges. International Journal of Health-System and Disaster Management, 4(1), 1.

Attipoe-Dorcoo, S., Delgado, R., Lai, D., Gupta, A., & Linder, S. (2020). Analysis of Annual

Costs of Mobile Clinics in the Southern United States. Journal of primary care &

community health, 11, 2150132720980623. https://doi.org/10.1177/2150132720980623

Brown-Connolly, N. E., Concha, J. B., & English, J. (2014). Mobile health is worth it! Economic

benefit and impact on the health of a population-based mobile screening program in New

Mexico. Telemedicine and e-Health, 20(1), 18-23.

Bouchelle, Z., Rawlins, Y., Hill, C., Bennet, J., Perez, L. X., & Oriol, N. (2017). Preventative

health, diversity, and inclusion: a qualitative study of client experience aboard a mobile

health clinic in Boston, Massachusetts. International journal for equity in health, 16(1),

1-10.

Health Research & Educational Trust. (2015, July). Diversity in Health Care: Examples from the

Field. Chicago, IL: Health Research & Educational Trust. Accessed at www.hpoe.org

Kirsch, N. R., Long, T., & Schmid, S. W. (n.d). Ethics for Professional Case Managers.

Continuing Education for Health Care Professionals.

Malone, N. C., Williams, M. M., Fawzi, M. C. S., Bennet, J., Hill, C., Katz, J. N., & Oriol, N. E.

(2020). Mobile health clinics in the United States. International journal for equity in

health, 19(1), 1-9.

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Stephanie, W. Y., Hill, C., Ricks, M. L., Bennet, J., & Oriol, N. E. (2017). The scope and impact

of mobile health clinics in the United States: a literature review. International journal for

equity in health, 16(1), 1-12.

Taylor, L. A., Coyle, C. E., Ndumele, C., Rogan, E., Canavan, M., Curry, L., & Bradley, E. H.

(2015). Leveraging the social determinants of health: What works? Blue Cross Blue

Shield of Massachusetts Foundation.

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Appendix 1
COST-BENEFIT ANALYSIS TEMPLATE

Current Year
Costs (CY) CY +1 CY +2 CY +3 CY +4 CY +5 Total Costs
Vehicle $ 20,000.00 $ - $ - $ - $ - $ -
Equipment- Refrigerator $ 2,000.00 $ - $ - $ - $ - $ -
Equipment- Autoclave $ 1,500.00 $ - $ - $ - $ - $ -
Equipment- Portable Dental chair $ 1,200.00 $ - $ - $ - $ - $ -
Equipment- Portable Dental chair x-ray $ 2,400.00 $ - $ - $ - $ - $ -
Insurance $ 3,500.00 $ 3,500.00 $ 3,500.00 $ 3,500.00 $ 3,500.00 $ 3,500.00
Fuel $ 5,000.00 $ 5,000.00 $ 5,000.00 $ 5,000.00 $ 5,000.00 $ 5,000.00
Maintenance $ - $ 10,000.00 $ 10,000.00 $ 10,000.00 $ 10,000.00 $ 10,000.00
Staff salries $ 550,000.00 $ 600,000.00 $ 650,000.00 $ 700,000.00 $ 750,000.00 $ 800,000.00
Other operating costs $ 245,000.00 $ 250,000.00 $ 265,000.00 $ 275,000.00 $ 285,000.00 $ 300,000.00
Total Costs (Future Value) $ 585,600.00 $ 618,500.00 $ 668,500.00 $ 718,500.00 $ 768,500.00 $ 818,500.00
Total Costs (Present Value) $ 585,600.00 $ 606,372.55 $ 642,541.33 $ 677,058.60 $ 709,975.21 $ 741,340.67 $ 3,962,888.35
blank row
Current Year
Benefits (CY) CY +1 CY +2 CY +3 CY +4 CY +5 Total Benefits
Increase in revenue $ 1,000,000.00 $ 1,500,000.00 $ 2,000,000.00 $ 2,500,000.00 $ 3,000,000.00 $ 3,500,000.00

Total Benefits (Future Value) $ 1,000,000.00 $ 1,500,000.00 $ 2,000,000.00 $ 2,500,000.00 $ 3,000,000.00 $ 3,500,000.00
Total Benefits (Present Value) $ 1,000,000.00 $ 1,470,588.24 $ 1,922,337.56 $ 2,355,805.84 $ 2,771,536.28 $ 3,170,057.83 $ 12,690,325.75
blank row
Present Value Discount Rate 2%
PV Denominator 1.00 1.02 1.04 1.06 1.08 1.10
Net Benefit $ 8,727,437.39
End of Worksheet