Evaluating Emergency Department Utilization among Undocumented Patients Receiving Care at a Community Health Clinic

Area of Science:

• Public Health
• Health Services Research
• Immigrant Health

Background:

• Undocumented immigrants face barriers to healthcare access, including insurance ineligibility and financial constraints.
• Community Health Clinics (CHCs) serve as a crucial healthcare source for this population.
• Limited research exists on emergency department (ED) utilization among undocumented immigrants who receive care at CHCs.

Purpose of the Study:

• To describe the characteristics of ED visits among undocumented immigrants with established care at a CHC.
• To identify the primary reasons for ED utilization in this population.
• To assess the preventability of these ED visits.

Main Methods:

• Cross-sectional study analyzing 319 patient records from a CHC serving a predominantly undocumented population (April 2023-April 2024).
• Extracted data included diagnoses, disposition, and utilization of the NYU ED algorithm (NYU-EDA) to assess preventability.
• Focused on visits by undocumented immigrants with established care at the CHC.

Main Results:

• Common diagnoses included infections (23%), injuries (22%), gastrointestinal diseases (16%), and OB/GYN diseases (11%).
• Most patients (81%) were discharged directly from the ED; 14% were admitted.
• Approximately 61% of ED visits were classified as preventable by the NYU-EDA.

Conclusions:

• A majority of ED visits by undocumented immigrants with CHC care were for acute issues and potentially preventable or treatable in primary care.
• Findings underscore the need for enhanced preventative care strategies and improved access to primary care services for undocumented populations.
• Results can inform interventions to address care gaps and promote equitable healthcare delivery for immigrant communities.