Dialysis in Undocumented Patients: Death on the Doorstep of the Emergency Department

Schneberk, Todd; Cooper, Richelle J.

doi:10.1016/j.annemergmed.2018.06.010

Cited by 1 publication

(1 citation statement)

References 24 publications

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“…Over the past several decades, restrictive policies and heightened immigration enforcement [1] have also been linked to reduced access to care for immigrants and their families [5][6][7][8]. Acute declines in health care utilization were observed following the 2016 U.S. Presidential election and amidst the COVID-19 public health crisis, which have led to reports of fear among immigrants in receiving testing and treatment [9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Provider and administrator-level perspectives on strategies to reduce fear and improve patient trust in the emergency department in times of heightened immigration enforcement

et al. 2021

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Study objectives Heightened immigration enforcement may induce fear in undocumented patients when coming to the Emergency Department (ED) for care. Limited literature examining health system policies to reduce immigrant fear exists. In this multi-site qualitative study, we sought to assess provider and system-level policies on caring for undocumented patients in three California EDs. Methods We recruited 41 ED providers and administrators from three California EDs (in San Francisco, Oakland, and Sylmar) with large immigrant populations. Participants were recruited using a trusted gatekeeper and snowball sampling. We conducted semi-structured interviews and analyzed the transcripts using constructivist grounded theory. Results We interviewed 10 physicians, 11 nurses, 9 social workers, and 11 administrators, and identified 7 themes. Providers described existing policies and recent policy changes that facilitate access to care for undocumented patients. Providers reported that current training and communication around policies is limited, there are variations between who asks about and documents status, and there remains uncertainty around policy details, laws, and jurisdiction of staff. Providers also stated they are taking an active role in building safety and trust and see their role as supporting undocumented patients. Conclusions This study introduces ED-level health system perspectives and recommendations for caring for undocumented patients. There is a need for active, multi-disciplinary ED policy training, clear policy details including the extent of providers’ roles, protocols on the screening and documentation of status, and continual reassessment of our health systems to reduce fear and build safety and trust with our undocumented communities.

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