Dental Clinic Comparison Chart: Capacity and Costs for Fixed Clinics, Mobile Clinics and Clinics Using Portable Equipment

 
Mode of Dental Care Delivery Pros Cons
Fixed Clinic Facility

Indications:
  • community-based clinic
  • community-based
  • if space is available and adequate for a clinic:
    • greater potential to optimize facility design and staffing (efficient and productive)
    • on-site lab and x-ray
  • can be co-located with other healthcare clinics
  • potential for sharing resources (e.g., waiting room, business office staff)
  • storage capacity for supplies and patient records
  • continuity of care
  • services limited to single geographic area
  • occupancy costs
  • patient transportation issues
  • need for low-income clients to leave work, which may be difficult
  • if available space is inadequate, it may force inefficient clinic design to fit space
Mobile: Self-Contained Motorized Van

Indications:
  • schools
  • rural areas
  • assisted living facilities
  • skilled nursing facilities
  • group homes
  • housing projects
  • other congregate settings (e.g., Head Start, day care)
  • migrant farmworker families
  • serve multiple populations in broad geographic areas (go where services are needed), many of which would not be able to support a fixed clinic
  • few limitations on locations
  • high visibility of program
    • potential funders: side of van becomes a "moving billboard" advertisement for funder
    • potential users: name recognition
  • the extent of limitations may depend on size (typical size = 25'- 40' in length)
  • on-site lab and x-ray possible
  • initial costs/operating costs may be higher
  • increased coordination required
  • may not be seen as "community-based"
  • community misperceptions and sometimes misused (e.g., perceptions of "emergency only" treatment)
  • continuity of care issues (e.g., "dental home" and emergency care after van has left community)
  • may have challenges finding providers
  • space may limit staff and productivity
  • limited space for supplies and records
  • may be adversely affected by weather conditions (e.g., cold, ice, extreme heat)
  • security/storage of vehicle/trailer
  • maintenance of vehicle/trailer
  • maneuverability (e.g., tight driving conditions on narrow streets)
  • fuel: if you run out, you're down
  • regulatory compliance (Americans with Disabilities Act, fire, etc.)
  • waste disposal (particularly hazardous materials)
  • need driver or training for dental staff to drive
  • increased risk for liability (e.g., motor vehicle accident)
Mobile: Trailer (Non-motorized)

areas that are secure and allow trailer to park for a period of time, such as schools or community centers
  • less expensive than motorized van
  • design more flexible than self-contained van (no cab to deal with)
  • less maintenance than self-contained van (no drive train)
  • other advantages are same as motorized van
  • need to contract with hauler or tow behind truck
  • size would limit where it can be parked and maneuvered
  • unable to move at short notice
  • many of the same disadvantages as mobile van
Portable Equipment

  • homebound
  • schools
  • rural
  • assisted living facilities
  • skilled nursing facilities
  • group homes
  • housing projects
  • other congregate settings (e.g., Head Start, day care)
  • migrant farmworker families
  • hospitals
  • initial costs lower
  • can serve multiple communities
  • adaptable to community changes (can leave a community if an access to care solution is found)
  • can "go where the people are located"
  • can expand options of a fixed facility or mobile clinic
  • least expensive capital investment
  • greatest versatility (reduces physical barriers)
  • relatively light
  • many options for combinations of equipment
  • maintenance sometimes easier
  • transportability
  • time and effort in packing and unpacking supplies and equipment each time
  • increased coordination required
  • may not be seen as "community-based"
  • environmental issues (light, temp, humidity)
  • reduced efficiency (e.g., lower capacity of vacuum and air compressor)
  • generator noise
  • requires space in facility
  • access to proper utilities
  • waste disposal (particularly hazardous materials)
  • range of services restricted
  • discomfort - patient and practitioner ergonomics
  • staff recruitment and retention
  • equipment durability
  • unlikely to have on-site lab services and equipment
  • x-ray processing is limited
  • storage needed for records, supplies
  • additional staff responsibilities (e.g., moving equipment)