Department of Health, Society, and Behavior, Anteater Instruction and Research Building (AIRB), UC Irvine Program in Public Health, 653 E. Peltason Road, Irvine, CA, 92697, USA.
Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
J Racial Ethn Health Disparities. 2023 Aug;10(4):2020-2027. doi: 10.1007/s40615-022-01382-8. Epub 2022 Aug 18.
To determine whether Latino undocumented immigrants had a steeper decline in Emergency Department (ED) utilization compared to Latino Medi-Cal patients in a Los Angeles safety-net hospital, March 13, 2020, to May 8, 2020.
The data were extracted from patient medical records for ED visits at LAC + USC Medical Center from January 2018 to September 2020. We analyzed weekly ED encounters among undocumented Latino patients in the nine-week period after COVID was declared a national emergency. We applied time-series routines to identify and remove autocorrelation in ED encounters before examining its relation with the COVID-19 pandemic. We included Latino patients 18 years of age and older who were either on restricted or full-scope Medi-Cal (n = 230,195).
All low-income Latino patients, regardless of immigration status, experienced a significant decline in ED utilization during the first nine weeks of the pandemic. Undocumented patients, however, experienced an even steeper decline. ED visits for this group fall below expected levels between March 13, 2020, and May 8, 2020 (coef. = - 38.67; 95% CI = - 71.71, - 5.63). When applied to the weekly mean of ED visits, this translates to a 10% reduction below expected levels in ED visits during this time period.
Undocumented immigrants' health care utilization was influenced by external events that occurred early in the pandemic, such as strict stay-at-home orders and the public charge rule change. Health care institutions and local policy efforts could work to ensure that hospitals are safer spaces for undocumented immigrants to receive care without immigration concerns.
确定在洛杉矶一家医疗保障医院，2020 年 3 月 13 日至 5 月 8 日期间，无身份移民的拉丁裔急诊就诊量是否比有医疗保障的拉丁裔患者下降得更严重。
数据取自 2018 年 1 月至 2020 年 9 月期间 LAC+USC 医疗中心的急诊就诊记录。我们分析了在宣布 COVID-19 为全国紧急事件后九周内，无身份拉丁裔患者每周的急诊就诊情况。在研究 COVID-19 大流行与急诊就诊量的关系之前，我们应用时间序列程序来识别和消除急诊就诊量的自相关性。我们纳入了年龄在 18 岁及以上、享受有限或全面医疗保障的拉丁裔患者（n=230195）。
所有低收入的拉丁裔患者，无论移民身份如何，在疫情的前九周都经历了急诊就诊量的显著下降。然而，无身份的患者经历了更为急剧的下降。该群体的急诊就诊量在 2020 年 3 月 13 日至 5 月 8 日之间低于预期水平（系数= -38.67；95%置信区间= -71.71，-5.63）。按每周平均急诊就诊量计算，这意味着在此期间急诊就诊量减少了 10%，低于预期水平。
无身份移民的医疗保健利用受到疫情早期外部事件的影响，例如严格的居家令和公共收费规则的改变。医疗保健机构和地方政策努力可以确保医院成为无身份移民在没有移民问题的情况下获得医疗服务的更安全场所。
