Immigrants and the cost of medical care.

Bing Center for Health Economics, RAND, Santa Monica, California, USA.
Health Affairs (Impact Factor: 4.64). 11/2006; 25(6):1700-11. DOI: 10.1377/hlthaff.25.6.1700
Source: PubMed

ABSTRACT 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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    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.
    Kontakt. 03/2014; 16(1):e1–e8.
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    ABSTRACT: The United States offers near-universal coverage for treatment of ESRD. Undocumented immigrants with ESRD are the only subset of patients not covered under a national strategy. There are 2 divergent dialysis treatment strategies offered to undocumented immigrants in the United States, emergent dialysis and chronic outpatient dialysis. Emergent dialysis, offering dialysis only when urgent indications exist, is the treatment strategy in certain states. Differing interpretations of Emergency Medicaid statute by the courts and state and federal government have resulted in the geographic disparity in treatment strategies for undocumented immigrants with ESRD. The Patient Protection and Affordable Care Act of 2010 ignored the health care of undocumented immigrants and will not provide relief to undocumented patients with catastrophic illness like ESRD, cancer, or traumatic brain injuries. The difficult patient and provider decisions are explored in this review. The Renal Physicians Association Position Statement on uncompensated renal-related care for noncitizens is an excellent starting point for a framework to address this ethical dilemma. The practice of "emergent dialysis" will hopefully be found unacceptable in the future because of the fact that it is not cost effective, ethical, or humane. Published by Elsevier Inc.
    Advances in Chronic Kidney Disease. 01/2015;
  • Annual Review of Public Health 03/2014; 36(1):150112150436006. · 6.63 Impact Factor

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