Cross-Sectional Study of Emergency Room Visits Among Hispanic Immigrants by Country of Origin

Hispanic immigrant populations from different areas of origin vary greatly in terms of demographic and economic factors. Studying differences in emergency department (ED) use is critical to understanding unmet needs for urgent medical attention. This study aims to uncover if individuals from different Hispanic backgrounds spend more money in the ED and suggest ways to mitigate these differences.

This cross-sectional study used the 2020 Medical Expenditure Panel Survey that collects information on ED expenditure among Hispanic adults born off the mainland USA aged 18 and above (N = 1838). We examined the association between four areas of origin (Mexico, Cuba, Puerto Rico, and the Dominican Republic) and two outcomes, including the number of ED visits per person and average expenditure. Survey-weighted multivariable regression models were conducted to evaluate how average expenditure varied by area of origin.

The results show that Dominicans spent $474.84 more than Mexicans per ED visit (p = 0.044). Dominicans spent the most out of the four origins, costing a total of $534.13. Average expenditures for Mexicans were negatively associated with speaking a different language than English and having a master's degree. For Puerto Ricans born on the island, average expenditures were negatively associated with low incomes (p = 0.044). Additionally, the average spending for Dominicans was negatively associated with living in the Midwest (p = 0.006).

This study demonstrates intra-ethnic differences in ED expenditures among Hispanic populations. Disaggregating data related to Hispanics is essential for identifying at-risk communities in which social outreach and preventative medicine initiatives can be targeted to prevent these differences.

1. This study identifies intra-group differences among immigrants from four Latin American countries/territories in terms of ED utilization and usage, an area that was previously limited in the current literature. 2. While Puerto Ricans had the highest number of visits per person, Dominicans spent the most in the ED and is mediated by their higher education and residency in Northeast areas. 3. Because ED utilization is a key data point for the health of a population, this study illustrates new information that can better help emergency medicine physicians and educators to train front line health workers and understand the population they take care of.