在2018年公开收费公告发布后,无证患者自行支付紧急病房访问
Alein Y Haro-Ramos1, Sarah Axeen2, Anna Gorman3
1Department of Health, Society, and Behavior, Joe C. Wen School of Population & Public Health, University of California, Irvine.
JAMA network open
|January 29, 2026
概括
2018年公开收费公告增加了2.10个百分点的自我支付急诊室 (ED) 访问,与美国出生的患者相比,可能是无证移民. 这一政策变化影响了支付模式和财务负担.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 移民政策 移民政策
背景情况:
- 2018年公开收费公告引起了无证移民对公共节目使用的担忧.
- 对紧急医疗补助和急救部门 (ED) 自付访问的影响尚不清楚.
研究的目的:
- 为了确定自付ED访问是否在可能的无证患者中增加,而不是在公开收费公告后的美国出生的患者.
- 分析ED访问支付状态的差异性变化.
主要方法:
- 洛杉矶县安全网医院ED遭遇的回顾性队列研究 (2017年5月 - 2019年12月).
- 将成年患者归类为可能是非法移民或美国出生的美国人.
- 利用差异差异和事件研究模型来评估自付ED访问在2018年9月公告后的变化.
主要成果:
- 分析了375,258次ED遭遇 (174,406人可能无证,200,852人出生在美国).
- 与美国出生的患者相比,在可能的无证患者中,自费ED访问增加了2.10个百分点,而在美国出生的患者中则增加了2.10个百分点.
- 事件研究模型显示,这种增长从2018年11月持续到2019年8月,达到17.8%的峰值.
结论:
- 在2018年公开收费公告发布后,可能无证患者的自付ED访问显著增加.
- 反移民政策可能会改变医疗保健支付模式,影响患者的财务负担和医院的财务.
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