Efficient frontiers in a frontier state: Viability of mobile dentistry services in rural areas

Abstract

This study investigates the implications of adding mobile dentistry services to a community health center (CHC) in a rural area. CHCs are not-for-profit healthcare organizations which provide comprehensive primary care services to patients in the US, primarily for under-served and uninsured populations. We estimate the demand for the service in a five-county region in southwestern Montana, USA and work with stakeholders to determine a set of potential service locations. A mixed-integer optimization model is formulated to determine the frequency of stops in each location over a finite (six month) planning horizon with the goal of improving accessibility and availability of dental services while maintaining financial sustainability of the CHC. The financial considerations and social impact of offering a mobile dentistry service in southwestern Montana are assessed. Computational results based on a case study demonstrate the challenges facing mobile dentistry operations to increase access to under-served populations in a financially viable manner. Hybrid solutions, in which care is offered at a mix of fixed locations and mobile locations, appear to best balance the objectives of financial sustainability and expanded access to care.

Delivering Mobile Dentistry to the Geriatric Population—The Future of Dentistry

“…The expectation is that the population awareness for dental treatment will rise, attracting the building of permanent dental facilities by private clinicians [14,15]. There have been studies that have mathematically modeled this form of mobile dentistry to determine which parameters can affect its business viability [16]. Fortunately, the model discussed here suffers from none of those intrinsic disadvantages.…”

Community Operational Research: Innovations, internationalization and agenda-setting applications

“…However, we note that Thorsen and McGarvey (2018) engaged with community-based service providers but not their clients. They differentiate between the UK tradition of Community OR, which requires community engagement, and the US literature on Community-Based Operations Research (CBOR), which requires stakeholder engagement only.…”

“…In addition to the above three papers on urban development, there are three more focused on the particular challenges of working in rural locations. The first is by Thorsen and McGarvey (2018), and it explores the financial feasibility of providing dental services to low-income and uninsured residents of Montana, USA, using mathematical programming models developed in collaboration with a local non-profit organization. In rural areas of Montana, eligible residents are widely dispersed, requiring periodic visits by mobile clinics.…”

Robust strategic planning for mobile medical units with steerable and unsteerable demands

“…To counteract the growing distances between patients and services, the overcoming of access barriers with the help of mobile medical units (MMUs) has been studied in many developed and developing countries; compare [10,55,38,30,53]. MMUs are customized vehicles fitted with medical equipment that are easy to relocate and can provide most of the health services a regular stationary practice could [38].…”

“…Although MMUs have been reported to operate in various modes, we will focus exclusively on a weekly recurring operation in clinical sessions as described in [53,10,55]. In this mode of operation, MMUs are stationed in larger cities (which they do not serve) and set out each day to provide health services at fixed sites in the surrounding rural communities.…”