Ethical issues in the access to emergency care for undocumented immigrants

Brenner, Jay M.; Blutinger, Erik J.; Ricke, Brandon; Vearrier, Laura; Kluesner, Nicholas H.; Moskop, John C.

doi:10.1002/emp2.12461

Cited by 6 publications

(9 citation statements)

References 32 publications

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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%

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

et al. 2022

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“…In the United States, among documented and undocumented immigrants, fears of being detained by ICE are a significant obstacle to seeking health care. In 2017–2018, almost a quarter of documented and undocumented Latino migrants reported that they had friends or family who did not come to the emergency department because of fear of arrest and deportation (Brenner et al, 2021; Hacker et al, 2015). In early 2020, the Trump administration changed the language on the public charge policy.…”

Section: Migration and The United Nations’ Sdgsmentioning

confidence: 99%

“…Without universal health care, imMigrants are far less likely than nonimMigrants to have health insurance coverage, a gap that is even wider for imMigrants with invisible status who cannot access federal health care such as Medicaid or insurance provided through the Affordable Care Act (ACA; Chang, 2019). For example, approximately 30% of children born in the United States whose parents are undocumented immigrants are uninsured compared with 4% of children whose parents are U.S. citizens (Brenner et al, 2021).…”

Section: Migration and The United Nations’ Sdgsmentioning

confidence: 99%

Health inequities and social determinants of health in refugee and immigrant communities.

Rami

Searight

Morrissey

et al. 2023

American Psychologist

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This article evaluates and elucidates the intersections across social and economic determinants of health and social structures that maintain current inequities and structural violence with a focus on the impact on imMigrants (immigrants and migrants), refugees, and those who remain invisible (e.g., people without immigration status who reside in the United States) from Black, Indigenous, and People of Color communities. Psychology has a history of treating individuals and families without adequately considering how trauma is cyclically and generationally maintained by structural violence, inequitable resources, and access to services. The field has not fully developed collaboration within an interdisciplinary framework or learning from best practices through international/global partnerships. Psychology has also been inattentive to the impact of structural violence prominent in impoverished communities. This structural harm has taken the form of the criminalization of imMigrants and refugees through detention, incarceration, and asylum citizenship processes. Most recently, the simultaneous occurrence of multiple catastrophic events, such as COVID-19, political polarization and unrest, police violence, and acceleration of climate change, has created a hypercomplex emergency for marginalized and vulnerable groups. We advance a framework that psychologists can use to inform, guide, and integrate their work. The foundation of this framework is select United Nations Sustainable Development Goals to address health inequities.

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Emergency care for undocumented immigrants

Wampler

Wang

2021

JACEP Open

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Ethical issues in the access to emergency care for undocumented immigrants

Cited by 6 publications

References 32 publications

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

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

Health inequities and social determinants of health in refugee and immigrant communities.

Emergency care for undocumented immigrants

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