Fenton J J, Moss N, Khalil H G, Asch S
Department of Family and Community Medicine, University of California, San Francisco, USA.
West J Med. 1997 Jan;166(1):16-20.
California's ballot proposition 187, passed by the voters in November 1994, threatened to discontinue undocumented immigrants' eligibility for most health services while mandating that health care professionals report suspected undocumented patients to authorities. Although the proposition has not been put into practice, reports suggest that its passage was associated with a decline in the use of health services by some groups. To assess the effects of the passage of Proposition 187 on the use of primary care services, we surveyed a representative sample of California clinics serving low-income groups (n = 129). Using a mailed questionnaire and phone interviews with clinic directors, we obtained qualitative and quantitative data regarding the effects of the passage of the proposition on clinic use. Among primary care clinics statewide and clinics serving predominantly Latino patients, we detected no significant decline in total monthly visits following the election. Nevertheless, half of clinic directors (51%) thought that the number of clinic visits declined after the passage of Proposition 187, and many directors thought that the deterrent effects of the election persisted for weeks to months after the election. Whereas the number of visits probably declined at some clinics, only a small minority of patients at most primary care clinics could have been deterred from seeking care after the passage of Proposition 187.
加利福尼亚州的第187号投票提案于1994年11月由选民通过，该提案威胁要取消无证移民获得大多数医疗服务的资格，同时要求医疗保健专业人员向当局报告疑似无证患者。尽管该提案尚未付诸实施，但报告显示其通过与一些群体医疗服务使用量的下降有关。为了评估第187号提案的通过对初级保健服务使用的影响，我们对加利福尼亚州为低收入群体服务的诊所进行了代表性抽样调查（n = 129）。通过邮寄问卷和对诊所主任进行电话访谈，我们获得了关于该提案通过对诊所使用影响的定性和定量数据。在全州的初级保健诊所和主要为拉丁裔患者服务的诊所中，我们发现在选举后每月的总就诊量没有显著下降。然而，一半的诊所主任（51%）认为在第187号提案通过后诊所就诊人数下降了，而且许多主任认为选举的威慑作用在选举后的数周甚至数月内仍然存在。虽然有些诊所的就诊人数可能下降了，但在第187号提案通过后，大多数初级保健诊所中只有一小部分患者可能被阻止寻求医疗服务。
