Optimizing care for uninsured and underserved children and families, a cross-sectional mixed-methods study of a mobile pediatric free clinic

Background The Pediatric Mobile Clinic (PMC) is a modified bus that travels throughout South Florida to provide free, high-quality healthcare for uninsured children and families closer to their place of residence. It is a clinic within the University of Miami Miller School of Medicine, Department of Pediatrics, Division of Community Pediatrics. The PMC serves a geographically and culturally diverse underserved population in South Florida. Methods We administered a tablet-based questionnaire focused on social determinants of health and barriers to care to consenting families in English, Spanish, and Haitian Creole. Patient demographics, various barriers to care, and clinical metrics were assessed and analyzed across the 44 respondents. Results Patients were a median of 9 years of age, with a decrease in respondents after age 12. Of survey patients, 89% identified as Hispanic and 16% identified as Black. Most families came to the PMC for vaccines, school physicals, or well child visits, with 56% of families reporting coming to the PMC because services are rendered free of charge. Of note, 40% of respondents reported they would not seek healthcare at all if unable to continue obtaining services at the PMC. A majority (51%) traveled 10 or more miles to reach us, despite the PMC traveling significant distances to reach patients across approximately 2,005 square kilometers. Conclusions We add to the evidence of a pediatric medical coverage gap, particularly among children of immigrants. We demonstrate an approach to mitigating the transportation challenges faced by many patients and particularly those from underserved areas. Trial Registration: This observational study is registered under IRB 20230613.