Asch S, Leake B, Gelberg L
Division of General Internal Medicine, Los Angeles County and University of Southern California Medical Center.
West J Med. 1994 Oct;161(4):373-6.
Physician groups are concerned that legislation requiring physicians to report illegal immigrants to immigration authorities will delay curative care. In particular, patients with tuberculosis may delay seeking care for infectious symptoms and spread the disease. We surveyed 313 consecutive patients with active tuberculosis from 95 different facilities to examine the relationship of immigration-related variables, symptoms, and delay in seeking care. Most patients (71%) sought care for symptoms rather than as a result of the efforts of public health personnel to screen high-risk groups or to trace contacts of infectious persons. At least 20% of respondents lacked legal documents allowing them to reside in the United States. Few (6%) feared that going to a physician might lead to trouble with immigration authorities. Those who did were almost 4 times as likely to delay seeking care for more than 2 months, a period of time likely to result in disease transmission. Patients potentially exposed an average of 10 domestic and workplace contacts during the course of the delay. Any legislation that increases undocumented immigrants' fear that health care professionals will report them to immigration authorities may exacerbate the current tuberculosis epidemic.
医生团体担心，要求医生向移民当局举报非法移民的立法会延误治疗。特别是，结核病患者可能会推迟因感染症状而寻求治疗，从而传播疾病。我们对来自95个不同机构的313例连续的活动性结核病患者进行了调查，以研究与移民相关的变量、症状和寻求治疗延迟之间的关系。大多数患者（71%）是因症状而寻求治疗，而非公共卫生人员筛查高危人群或追踪感染者接触者的结果。至少20%的受访者没有允许他们在美国居住的法律文件。很少有人（6%）担心看医生可能会导致与移民当局产生麻烦。那些担心的人延迟寻求治疗超过2个月的可能性几乎是其他人的4倍，而这段时间很可能导致疾病传播。在延迟期间，患者平均可能会使10名家庭和工作场所接触者暴露于疾病之中。任何增加无证移民担心医疗保健专业人员会向移民当局举报他们的立法，都可能加剧当前的结核病流行。
