Immigrants And The Cost Of Medical Care

RAND Corporation, Santa Monica, California, United States
Health Affairs (Impact Factor: 4.97). 11/2006; 25(6):1700-11. DOI: 10.1377/hlthaff.25.6.1700
Source: PubMed


Foreign-born adults in Los Angeles County, California, constituted 45 percent of the county's population ages 18-64 but accounted for 33 percent of health spending in 2000. Similarly, the undocumented constituted 12 percent of the nonelderly adult population but accounted for only 6 percent of spending. Extrapolating to the nation, total spending by the undocumented is 6.4 billion dollars , of which only 17 percent (1.1 billion dollars) is paid for by public sources. The foreign-born (especially the undocumented) use disproportionately fewer medical services and contribute less to health care costs in relation to their population share, likely because of their better relative health and lack of health insurance.

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Available from: Neeraj Sood,
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    • "As studies [8] [9] [10] [11] [12] confirm, migrants constitute a vulnerable minority with restricted access to health care. The unequal conditions are caused particularly by the socio-economic status [2] [11] [12], by the immigration status [13], by the language barriers [14] or by the marginalization and stigmatization of individual ethnic minorities [1] [15] [16]. The so-called healthy immigrant effect is sometimes mentioned in this context also [17] [18] [19] [20]; that term describes the status when immigrants have better health condition than the majority population after their arrival in the host country. "
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    ABSTRACT: Research studies have shown that the health condition of immigrants is not influenced only by gender differences; significant determinants also include ethnicity, consistency of cultural heritage and social class. In relation to their status, immigrants belong to a vulnerable group with a higher incidence of a number of illnesses [1] and [2]. The submitted article is focused on mapping the influence of four basic factors – ethnicity, degree of acculturation, immigration status and the socio-professional position on the immigrants’ health. The influence was described with the help of a secondary analysis of relevant sources using electronic databases including Scopus, EBSCO, etc. To map the ascertained factors, the conceptual model of basic determinants influencing the immigrants’ health was created, considering health a multidimensional result subject to external and internal determinants with emphasis on key aspects. Those aspects were further analysed and confronted with research projects and conclusions implemented in the Czech Republic and in other countries of the world. Although the mutual influence of the determinants was proved by studies, the European region still sees a priority rather in the social and economic self-sufficiency of the individual. The immigrants’ health has not yet been sufficiently mapped, as is evidenced by the survey of research activities focused on this issue in the Czech Republic.
    03/2014; 16(1):e1–e8. DOI:10.1016/j.kontakt.2014.01.003
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    • "The proportion of medical expenditures paid out-of-pocket was slightly higher among immigrant workers compared to U.S.-born workers, but this difference was not statistically significant. This finding is consistent with previous studies that reported a slightly higher proportion of medical expenditures paid-out-of-pocket among immigrant adults in comparison with U.S.-born adults [19,35]. Another study of immigrant children’s medical care also found that Spanish speakers had 1.5 times the odds of spending $500 or more out-of-pocket medical expenditures per year than English speakers. "
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    ABSTRACT: Background No national study has investigated whether immigrant workers are less likely than U.S.-workers to seek medical treatment after occupational injuries and whether the payment source differs between two groups. Methods Using the 2004–2009 Medical Expenditure Panel Survey (MEPS) data, we estimated the annual incidence rate of nonfatal occupational injuries per 100 workers. Logistic regression models were fitted to test whether injured immigrant workers were less likely than U.S.-born workers to seek professional medical treatment after occupational injuries. We also estimated the average mean medical expenditures per injured worker during the 2 year MEPS reference period using linear regression analysis, adjusting for gender, age, race, marital status, education, poverty level, and insurance. Types of service and sources of payment were compared between U.S.-born and immigrant workers. Results A total of 1,909 injured U.S.-born workers reported 2,176 occupational injury events and 508 injured immigrant workers reported 560 occupational injury events. The annual nonfatal incidence rate per 100 workers was 4.0% (95% CI: 3.8%-4.3%) for U.S.-born workers and 3.0% (95% CI: 2.6%-3.3%) for immigrant workers. Medical treatment was sought after 77.3% (95% CI: 75.1%-79.4%) of the occupational injuries suffered by U.S.-born workers and 75.6% (95% CI: 69.8%-80.7%) of the occupational injuries suffered by immigrant workers. The average medical expenditure per injured worker in the 2 year MEPS reference period was $2357 for the U.S.-born workers and $2,351 for immigrant workers (in 2009 U.S. dollars, P = 0.99). Workers’ compensation paid 57.0% (95% CI: 49.4%-63.6%) of the total expenditures for U.S.-born workers and 43.2% (95% CI: 33.0%-53.7%) for immigrant workers. U.S.-born workers paid 6.7% (95% CI: 5.5%-8.3%) and immigrant workers paid 7.1% (95% CI: 5.2%-9.6%) out-of-pocket. Conclusions Immigrant workers had a statistically significant lower incidence rate of nonfatal occupational injuries than U.S.-born workers. There was no significant difference in seeking medical treatment and in the mean expenditures per injured worker between the two groups. The proportion of total expenditures paid by workers’ compensation was smaller (marginally significant) for immigrant workers than for U.S.-born workers.
    BMC Public Health 08/2012; 12(1):678. DOI:10.1186/1471-2458-12-678 · 2.26 Impact Factor
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    • "It is a universal and practically free system (there is only a reduced co-payment for outpatient prescription drugs). The health system operates in the same way for the immigrant population, including those whose status in the country is irregular [11], which should improve real access to it [12, 13]. There is only one condition: to be registered on the census—this does not involve any risks to individuals who are in an irregular administrative situation. "
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    ABSTRACT: Knowing what real use is made of health services by immigrant population is of great interest. The objectives are to analyze the use of primary care services by immigrants compared to Spanish nationals and to analyze these differences in relation to geographic origin. Retrospective observational study of all primary care visits made in 26 urban health centers. Main variable: total number of health centre visits/year. Dependent variables: type of clinician requested; type of attention, and origin of immigrants. The independent variable was nationality. Statistics were obtained from the electronic medical records. The 4,933,521 appointments made in 2007 were analyzed for a reference population of 594,145 people (11.15 % immigrants). The adjusted annual frequency for nationals was 8.3, versus whereas 4.6 for immigrants. The immigrant population makes less use of primary care services than national population. This is evident for all age groups and regardless of the immigrants' countries of origin. This result is important when planning health care resources for immigrant population.
    Journal of Immigrant and Minority Health 05/2012; 15(3). DOI:10.1007/s10903-012-9647-x · 1.16 Impact Factor
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