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将联邦移民医学检查纳入美国学生运营的免费诊所。

Implementing Federal Immigration Medical Examinations into a United States Student-Run Free Clinic.

作者信息

Siliezar Julio, Rodriguez Paola, Arroyo-Velazquez Yakelin, Aguirre Siliezar Kimberly, Venegas Melanie, Melchor Carlos, Stierli Micah, Diaz Mark, Tu Brenden, Wilkes Michael

机构信息

University of California Davis School of Medicine, Sacramento, CA, USA.

University of California Davis School of Veterinary Medicine, Davis, CA, USA.

出版信息

J Community Health. 2025 Jun 9. doi: 10.1007/s10900-025-01488-0.

Abstract

The Immigration Medical Examination (IME) is a mandatory step in obtaining U.S. permanent residency, yet its high cost and limited accessibility pose significant barriers for low-income immigrants. Addressing these challenges is critical to ensuring equitable healthcare access for underserved populations. To present the benefits and process of integrating IME services into a student-run free clinic serving low-income immigrant populations. A review of IME requirements, cost barriers, and existing student-run clinic models informed the development of an IME program at the Knights Landing One Health Center (KLOHC). The implementation process involved four key steps: assessing community needs, securing qualified personnel, establishing clinic logistics, and implementing a structured training model for student volunteers. A retrospective chart review of patients receiving IME services from May 2022 to May 2024 was conducted to analyze patient demographics, service utilization, and health screening outcomes. KLOHC provided IME services to 204 patients, with 177 adult records analyzed. The majority were Hispanic/Latino (84%) and Spanish-speaking (79%), highlighting the importance of culturally and linguistically competent care. Patient volume steadily increased, with a consistent waitlist of 14-20 individuals per session. Cost reduction was significant, with services provided at no cost for selected cities already served by KLOHC. These cities include Knights Landing, Davis, Winters, Woodland (Yolo County), Yuba City (Sutter County), and Sacramento (Sacramento County). A $250 was charged to non-target community patients, compared to the private sector's $400-$900 range. IME health screenings identified cases of tuberculosis and sexually transmitted infections, enabling timely treatment. The structured student leadership model ensured continuity, training, and sustainability. Integrating IME services into student-run clinics is a feasible and effective strategy to expand access to essential health evaluations for immigrant populations. Funds collected from non-target communities were used to pay for vaccines, x-rays, and transportation for target community members which eased the financial burden of the already expensive immigration process. KLOHC's model demonstrates a cost-effective service for patients, improves healthcare accessibility, and provides hands-on training for future healthcare professionals. This initiative serves as a replicable framework for other student-run clinics nationwide, addressing a critical gap in immigrant healthcare and promoting a more equitable healthcare system.

摘要

移民体检(IME)是获得美国永久居留权的一个必要步骤,但其高昂的费用和有限的可及性给低收入移民带来了重大障碍。应对这些挑战对于确保为服务不足的人群提供公平的医疗服务至关重要。介绍将移民体检服务整合到一个由学生运营的、为低收入移民人群服务的免费诊所中的益处和流程。对移民体检要求、成本障碍以及现有的学生运营诊所模式进行审查,为骑士登陆一体化健康中心(KLOHC)的移民体检项目的开展提供了参考。实施过程包括四个关键步骤:评估社区需求、确保有资质的人员、建立诊所后勤保障以及为学生志愿者实施结构化培训模式。对2022年5月至2024年5月期间接受移民体检服务的患者进行回顾性病历审查,以分析患者人口统计学特征、服务利用情况和健康筛查结果。KLOHC为204名患者提供了移民体检服务,分析了177份成人病历。大多数患者为西班牙裔/拉丁裔(84%)且说西班牙语(79%),这凸显了具有文化和语言能力的护理的重要性。患者数量稳步增加,每次就诊都有14 - 20人的稳定等候名单。成本显著降低,对于KLOHC已经服务的特定城市,服务免费提供。这些城市包括骑士登陆、戴维斯、温特斯、伍德兰(约洛县)、尤巴城(萨特县)和萨克拉门托(萨克拉门托县)。非目标社区的患者收取250美元,而私营部门的收费在400 - 900美元之间。移民体检健康筛查发现了结核病和性传播感染病例,得以及时治疗。结构化的学生领导模式确保了连续性、培训和可持续性。将移民体检服务整合到学生运营的诊所是一种可行且有效的策略,可扩大移民人群获得基本健康评估的机会。从非目标社区收取的资金用于为目标社区成员支付疫苗、X光检查和交通费用,这减轻了本就昂贵的移民过程的经济负担。KLOHC的模式为患者展示了一种具有成本效益的服务,提高了医疗可及性,并为未来的医疗专业人员提供了实践培训。这一举措为全国其他学生运营的诊所提供了一个可复制的框架,解决了移民医疗中的一个关键差距,并促进了一个更加公平的医疗系统。

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