Health Care Use Among Latinx Children After 2017 Executive Actions on Immigration.
Ambulatory Care Facilities
/ legislation & jurisprudence
Appointments and Schedules
Child
Child, Preschool
Emigrants and Immigrants
/ legislation & jurisprudence
Emigration and Immigration
/ legislation & jurisprudence
Female
Health Policy
/ legislation & jurisprudence
Hispanic or Latino
/ legislation & jurisprudence
Humans
Interrupted Time Series Analysis
/ legislation & jurisprudence
Male
North Carolina
/ epidemiology
Patient Acceptance of Health Care
Journal
Pediatrics
ISSN: 1098-4275
Titre abrégé: Pediatrics
Pays: United States
ID NLM: 0376422
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
accepted:
06
10
2020
pubmed:
25
10
2020
medline:
16
6
2021
entrez:
24
10
2020
Statut:
ppublish
Résumé
US immigration policy changes may affect health care use among Latinx children. We hypothesized that January 2017 restrictive immigration executive actions would lead to decreased health care use among Latinx children. We used controlled interrupted time series to estimate the effect of executive actions on outpatient cancellation or no-show rates from October 2016 to March 2017 ("immigration action period") among Latinx children in 4 health care systems in North Carolina. We included control groups of (1) non-Latinx children and (2) Latinx children from the same period in the previous year ("control period") to account for natural trends such as seasonality. In the immigration action period, 114 627 children contributed 314 092 appointments. In the control period, 107 657 children contributed 295 993 appointments. Relative to the control period, there was an immediate 5.7% (95% confidence interval [CI]: 0.40%-10.9%) decrease in cancellation rates among all Latinx children, but no sustained change in trend of cancellations and no change in no-show rates after executive immigration actions. Among uninsured Latinx children, there was an immediate 12.7% (95% CI: 2.3%-23.1%) decrease in cancellations; however, cancellations then increased by 2.4% (95% CI: 0.89%-3.9%) per week after immigration actions, an absolute increase of 15.5 cancellations per 100 appointments made. There was a sustained increase in cancellations among uninsured Latinx children after immigration actions, suggesting decreased health care use among uninsured Latinx children. Continued monitoring of effects of immigration policy on child health is needed, along with measures to ensure that all children receive necessary health care.
Sections du résumé
BACKGROUND
US immigration policy changes may affect health care use among Latinx children. We hypothesized that January 2017 restrictive immigration executive actions would lead to decreased health care use among Latinx children.
METHODS
We used controlled interrupted time series to estimate the effect of executive actions on outpatient cancellation or no-show rates from October 2016 to March 2017 ("immigration action period") among Latinx children in 4 health care systems in North Carolina. We included control groups of (1) non-Latinx children and (2) Latinx children from the same period in the previous year ("control period") to account for natural trends such as seasonality.
RESULTS
In the immigration action period, 114 627 children contributed 314 092 appointments. In the control period, 107 657 children contributed 295 993 appointments. Relative to the control period, there was an immediate 5.7% (95% confidence interval [CI]: 0.40%-10.9%) decrease in cancellation rates among all Latinx children, but no sustained change in trend of cancellations and no change in no-show rates after executive immigration actions. Among uninsured Latinx children, there was an immediate 12.7% (95% CI: 2.3%-23.1%) decrease in cancellations; however, cancellations then increased by 2.4% (95% CI: 0.89%-3.9%) per week after immigration actions, an absolute increase of 15.5 cancellations per 100 appointments made.
CONCLUSIONS
There was a sustained increase in cancellations among uninsured Latinx children after immigration actions, suggesting decreased health care use among uninsured Latinx children. Continued monitoring of effects of immigration policy on child health is needed, along with measures to ensure that all children receive necessary health care.
Identifiants
pubmed: 33097659
pii: peds.2020-0272
doi: 10.1542/peds.2020-0272
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2021 by the American Academy of Pediatrics.
Déclaration de conflit d'intérêts
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.