121 - The Johns Hopkins Bayview Care-A-Van: Describing the Healthcare Characteristics and Needs of Pediatric Patients Attending a Mobile Clinic

Poster Number: 121
Publication Number: 121.410

Daniel Sylvester, Johns Hopkins Children's Center, Baltimore, MD, United States; Sarah Polk, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Veena Billioux, Johns Hopkins University School of Medicine, Baltimore, MD, United States

Background: There are about 2000 mobile health clinics (MHCs) in the US, with up to 6.5 million visits annually. Many MHCs care for underserved patients. Benefits include diagnosing chronic health conditions, positive patient experiences, improved surrogate disease markers, and return on investment. In pediatrics, MHCs have been used in asthma care and vaccinations, but little published data exists. The Care-A-Van is an MHC providing free pediatric care to uninsured children in Baltimore, MD. Services include primary care, immunizations, and referrals to prenatal care. There has not been a review of its patient data.
 

Objective: Characterize the medical and demographic characteristics of patients using the Care-A-Van.

Design/Methods: Medical/demographic data for 0-18 year olds visiting the Care-A-Van 11/2/2016 - 2/29/2020 were extracted from the electronic medical record. Descriptive statistics were performed using Stata.

Results: 1,052 individual patients were seen over 2,026 visits, with an average 1.9 visits per patient. 94.6% of patients identified as Hispanic or Latino. 84% of patients were 2-13 years old. There were 240 unique diagnoses. The 10 most common were 78.8% of all diagnoses, with routine exam without abnormal findings and immunizations making up 46.7% of all diagnoses. There were 9 mental health diagnoses over 14 entries, and 5 developmental delays/disorders over 22 entries.
We further examined two common diagnoses: anemia and obesity. Our 446 unique hemoglobin measurements were compared to mean hemoglobin and average rates of anemia for age per AAFP guidelines. The rate of anemia by age group ranged from 6.7% to 29.9%. 987 BMIs were recorded: 68.4% of patients had a single BMI measurement charted, 19.2% had two, and < 5% had 3+. BMIs by age category were fairly stable over time.Conclusion(s): The Care-A-Van serves the local community by providing pediatric care to predominantly Latinx children in Baltimore. The rate of mental health and developmental diagnoses was much lower than in national samples (1.2% vs 17.4% of 2-8 year-olds, respectively). In our sample, 2-6 year-olds and 12-18 year-old females had lower mean hemoglobin than average for age. Our sample was less obese than the general pediatric population. Lack of repeat visits may indicate referrals to PCPs or loss to follow up. High frequency of TB screening likely reflects more immigrants, as MD was 6th in FY2021 for unaccompanied minors released to sponsors. More study is needed to best serve the needs of these patients and explore the Care-A-Van’s role in addressing care gaps.
Figure 1. Diagnoses as % of Total Encounter DiagnosesVisual representation of recorded diagnoses for Care-A-Van patients
Table 1. Age Characteristics and Mean Encounters by Age GroupAge distribution of Care-A-Van patients and mean encounters by age group and gender