Fewer immigrants have preventable emergency department visits in the United States

Yang Wang, Fernando Wilson, Jim P. Stimpson, Hongmei Wang, David W Palm, Baojiang Chen, Li-Wu Chen

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: The aim of this study is to examine differences in having preventable emergency department (ED) visits between noncitizens, naturalized and US-born citizens in the United States. Methods: We linked the 2008-2012 Medical Expenditure Panel Survey with National Health Interview Survey data to draw a nationally representative sample of US adults. Univariate analysis described distribution of preventable ED visits identified by the Prevention Quality Indicators across immigration status. We also assessed the association between preventable ED visits and immigration status, controlling for demographics, socioeconomic status, health service utilization, and health status. We finally applied the Oaxaca-Blinder decomposition method to measure the contribution of each covariate to differences in preventable ED services utilization between US natives, naturalized citizens, and noncitizens. Results: Of US natives, 2.1% had any preventable ED visits within the past years as compared to 1.0% of noncitizens and 1.5% of naturalized citizens. Multivariate results also revealed that immigrants groups had significantly lower odds (adjusted OR: naturalized citizen 0.77 [0.61-0.96], noncitizen 0.62 [0.48-0.80]) of having preventable ED visits than natives. Further stratified analysis by insurance status showed these differences were only significant among the uninsured and public insurance groups. Race/ethnicity and health insurance explained about 68% of the difference in preventable ED service utilization between natives and noncitizens. Conclusion: Our study documents the existing differences in preventable ED visits across immigration status, and highlights the necessity to explore unmet health needs among immigrants and eliminate disparities.

Original languageEnglish (US)
JournalAmerican Journal of Emergency Medicine
DOIs
StateAccepted/In press - 2017

Fingerprint

Hospital Emergency Service
Population Groups
Emigration and Immigration
Insurance Coverage
Health Insurance
Health Expenditures
Health Surveys
Insurance
Social Class
Health Status
Health Services
Demography
Interviews
Health

Keywords

  • Healthcare disparities
  • Immigrants
  • Preventable ED visits

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

@article{3b9c9c1a17834e5f8232d15b2b6f2ae1,
title = "Fewer immigrants have preventable emergency department visits in the United States",
abstract = "Objective: The aim of this study is to examine differences in having preventable emergency department (ED) visits between noncitizens, naturalized and US-born citizens in the United States. Methods: We linked the 2008-2012 Medical Expenditure Panel Survey with National Health Interview Survey data to draw a nationally representative sample of US adults. Univariate analysis described distribution of preventable ED visits identified by the Prevention Quality Indicators across immigration status. We also assessed the association between preventable ED visits and immigration status, controlling for demographics, socioeconomic status, health service utilization, and health status. We finally applied the Oaxaca-Blinder decomposition method to measure the contribution of each covariate to differences in preventable ED services utilization between US natives, naturalized citizens, and noncitizens. Results: Of US natives, 2.1{\%} had any preventable ED visits within the past years as compared to 1.0{\%} of noncitizens and 1.5{\%} of naturalized citizens. Multivariate results also revealed that immigrants groups had significantly lower odds (adjusted OR: naturalized citizen 0.77 [0.61-0.96], noncitizen 0.62 [0.48-0.80]) of having preventable ED visits than natives. Further stratified analysis by insurance status showed these differences were only significant among the uninsured and public insurance groups. Race/ethnicity and health insurance explained about 68{\%} of the difference in preventable ED service utilization between natives and noncitizens. Conclusion: Our study documents the existing differences in preventable ED visits across immigration status, and highlights the necessity to explore unmet health needs among immigrants and eliminate disparities.",
keywords = "Healthcare disparities, Immigrants, Preventable ED visits",
author = "Yang Wang and Fernando Wilson and Stimpson, {Jim P.} and Hongmei Wang and Palm, {David W} and Baojiang Chen and Li-Wu Chen",
year = "2017",
doi = "10.1016/j.ajem.2017.08.018",
language = "English (US)",
journal = "The American journal of emergency medicine",
issn = "0735-6757",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - Fewer immigrants have preventable emergency department visits in the United States

AU - Wang, Yang

AU - Wilson, Fernando

AU - Stimpson, Jim P.

AU - Wang, Hongmei

AU - Palm, David W

AU - Chen, Baojiang

AU - Chen, Li-Wu

PY - 2017

Y1 - 2017

N2 - Objective: The aim of this study is to examine differences in having preventable emergency department (ED) visits between noncitizens, naturalized and US-born citizens in the United States. Methods: We linked the 2008-2012 Medical Expenditure Panel Survey with National Health Interview Survey data to draw a nationally representative sample of US adults. Univariate analysis described distribution of preventable ED visits identified by the Prevention Quality Indicators across immigration status. We also assessed the association between preventable ED visits and immigration status, controlling for demographics, socioeconomic status, health service utilization, and health status. We finally applied the Oaxaca-Blinder decomposition method to measure the contribution of each covariate to differences in preventable ED services utilization between US natives, naturalized citizens, and noncitizens. Results: Of US natives, 2.1% had any preventable ED visits within the past years as compared to 1.0% of noncitizens and 1.5% of naturalized citizens. Multivariate results also revealed that immigrants groups had significantly lower odds (adjusted OR: naturalized citizen 0.77 [0.61-0.96], noncitizen 0.62 [0.48-0.80]) of having preventable ED visits than natives. Further stratified analysis by insurance status showed these differences were only significant among the uninsured and public insurance groups. Race/ethnicity and health insurance explained about 68% of the difference in preventable ED service utilization between natives and noncitizens. Conclusion: Our study documents the existing differences in preventable ED visits across immigration status, and highlights the necessity to explore unmet health needs among immigrants and eliminate disparities.

AB - Objective: The aim of this study is to examine differences in having preventable emergency department (ED) visits between noncitizens, naturalized and US-born citizens in the United States. Methods: We linked the 2008-2012 Medical Expenditure Panel Survey with National Health Interview Survey data to draw a nationally representative sample of US adults. Univariate analysis described distribution of preventable ED visits identified by the Prevention Quality Indicators across immigration status. We also assessed the association between preventable ED visits and immigration status, controlling for demographics, socioeconomic status, health service utilization, and health status. We finally applied the Oaxaca-Blinder decomposition method to measure the contribution of each covariate to differences in preventable ED services utilization between US natives, naturalized citizens, and noncitizens. Results: Of US natives, 2.1% had any preventable ED visits within the past years as compared to 1.0% of noncitizens and 1.5% of naturalized citizens. Multivariate results also revealed that immigrants groups had significantly lower odds (adjusted OR: naturalized citizen 0.77 [0.61-0.96], noncitizen 0.62 [0.48-0.80]) of having preventable ED visits than natives. Further stratified analysis by insurance status showed these differences were only significant among the uninsured and public insurance groups. Race/ethnicity and health insurance explained about 68% of the difference in preventable ED service utilization between natives and noncitizens. Conclusion: Our study documents the existing differences in preventable ED visits across immigration status, and highlights the necessity to explore unmet health needs among immigrants and eliminate disparities.

KW - Healthcare disparities

KW - Immigrants

KW - Preventable ED visits

UR - http://www.scopus.com/inward/record.url?scp=85027708459&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85027708459&partnerID=8YFLogxK

U2 - 10.1016/j.ajem.2017.08.018

DO - 10.1016/j.ajem.2017.08.018

M3 - Article

JO - The American journal of emergency medicine

JF - The American journal of emergency medicine

SN - 0735-6757

ER -