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The effects of California Proposition 187 on ophthalmology clinic utilization at an inner-city urban hospital
J L Marx1, A B Thach, G Grayson
1Department of Ophthalmology, University of Southern California School of Medicine, Doheny Eye Institute, Los Angeles 90033, USA.
Insights
California Proposition 187 temporarily decreased new walk-in patients at an inner-city ophthalmology clinic. Utilization returned to normal after legal challenges, indicating no lasting impact on clinic access for undocumented immigrants.
Area of Science:
- Public Health
- Health Services Research
- Immigration Policy Impact
Background:
- California Proposition 187 aimed to restrict social services for undocumented immigrants.
- The proposition sparked significant debate regarding its impact on healthcare access.
- Public inner-city hospitals serve a vulnerable patient population, including undocumented immigrants.
Purpose of the Study:
- To assess the effect of California Proposition 187 on ophthalmology clinic utilization.
- To analyze changes in patient volume and behavior surrounding the proposition's passage.
- To determine the short-term and long-term impacts on healthcare access.
Main Methods:
- Analysis of ophthalmology clinic volume at a major public hospital.
- Comparison of patient data from October 1 to December 31, 1993, and 1994.
- Evaluation of new patient visits, cancellations, no-shows, and return patient behavior.
Main Results:
- A statistically significant decrease in new walk-in patients was observed for two months post-election (P < 0.001).
- New patient cancellation and no-show rates remained unaffected.
- No changes in return patient behavior were noted for general or specialty clinics.
Conclusions:
- Proposition 187 may have caused a temporary reduction in new walk-ins to ophthalmology clinics.
- The study found no measurable effect on other utilization indicators or return patient behavior.
- Clinic utilization returned to baseline after legal injunctions, alleviating provider reporting concerns.
Purpose:
To determine the effect on ophthalmology clinic utilization at a major public inner-city hospital of California Proposition 187 and the debate surrounding its passage. Proposition 187 was a statewide referendum passed by 63% of the electorate in the November 1994 election that would restrict social services to undocumented immigrants and require providers to report them to immigration authorities.
Methods:
The ophthalmology clinic volume at the Los Angeles County/ University of Southern California Medical Center was analyzed from October 1 to December 31, 1993 and 1994.
Results:
New walk-in patients significantly decreased (P < 0.001) for a 2-month period around the election, but returned to baseline levels in December 1994. The new patient cancellation and no show rate was not affected. No change in return patient behavior was noted for general and specialty clinics.
Conclusions:
Proposition 187 may have caused a statistically significant decrease in new walk-ins to the ophthalmology clinics during a 2-month period surround the November 1994 election, but it had no measurable effect on other indicators of utilization. In addition, utilization rates returned to baseline after the implementation of Proposition 187 was stayed by the judicial system, and concern that providers would be required to report undocumented immigrants to authorities was alleviated.