Emergency care for undocumented immigrants

Wampler, David; Wang, Henry E.

doi:10.1002/emp2.12481

Cited by 1 publication

(3 citation statements)

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“…Consequently, there is much variability with regard to the care patients receive. This study underscores the importance of the ED as a safety net for the most vulnerable populations 26,27 …”

Section: Discussionmentioning

confidence: 66%

“…This study underscores the importance of the ED as a safety net for the most vulnerable populations. 26,27 In addition to the uninsured ED HD, there were 172,889 insured ED visits associated with HD, totaling over $1.8 billion in hospital charges. Our findings suggest that even though insured individuals with ESKD are eligible for chronic and scheduled dialysis (HD and PD) funded by Medicare and Medicaid, they also contribute to the enormous health care burden of ED HD.…”

Section: Discussionmentioning

confidence: 99%

“…This study underscores the importance of the ED as a safety net for the most vulnerable populations. 26 , 27 …”

Section: Discussionmentioning

confidence: 99%

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Emergency department visits for hemodialysis by insurance status in the United States

et al. 2022

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Objective Many uninsured patients with end‐stage kidney disease (ESKD) depend upon the emergency department (ED) for hemodialysis (HD). We sought to characterize ED visits for emergent HD by insurance status. Methods We performed a cross‐sectional analysis of the 2017 Nationwide Emergency Department Sample, including ED visits by patients ≥18 years old with a length of stay ≤1 day and performance of HD. Insurance status determined by “insured” as Medicare, Medicaid, or commercial and “uninsured” as self‐pay or charity. Results Of 118,034,396 adult ED visits, 235,988 were associated with HD: uninsured 62,503 (incidence 5.30 per 10,000, 95% confidence interval [CI]: 5.26–5.34) and insured 172,889 (incidence 14.65 per 10,000, 95% CI: 14.60–14.74). The south census region accounted for 89% of uninsured ED HD (odds ratio [OR] 31.55, 95% CI: 8.97–110.97). Compared to insured patients, uninsured ED HD patients were more likely to be younger (age 18–44, 37.6% vs 19.9%). The most common primary diagnosis for uninsured and insured ED HD patients was hypertensive chronic kidney disease (34.6% and 26.2%, respectively). Uninsured ED HD patients were less likely to be admitted (3.4% vs 36.0%, OR 0.06, 95% CI: 0.02–0.20). Most ED HD patients were discharged home (95.2% uninsured vs 57.6% insured). ED charges per visit were $5,992.32 for uninsured and $10,985.87 for insured ED HD patients. Conclusions Our findings highlight the health care burden of ED HD. Novel system approaches are needed for the management of uninsured and insured patients with ESKD.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%