Changes in Insurance Coverage and Healthcare Use Among Immigrants and US-Born Adults Following the Affordable Care Act

Tarraf, Wassim; Jensen, Gail A.; Li, Yuyi; Toseef, Mohammad Usama; Mahmoudi, Elham; González, Héctor M.

doi:10.1007/s40615-020-00790-y

Cited by 9 publications

(6 citation statements)

References 46 publications

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“…There was also a substantial difference in usual source of care by country of birth (Table 2). The proportion reporting a doctor's office as usual source of care was highest among Vietnamese-born persons at 73% (CI: 66-81) and lowest among Mexican-born persons, 31% (CI: [24][25][26][27][28][29][30][31][32][33][34]. The proportion reporting no usual source of care was highest among Mexican-born persons at 28% (CI: 26-30) and lowest among Indian-born persons at 11% (CI: 6-15).…”

Section: Healthcare Utilization and Barriers To Carementioning

confidence: 99%

“…Among U.S.-born, 54% (CI: 52-55) reported very good or excellent health. Lower proportions of good or excellent health were reported by persons born in Mexico or in Vietnam: 26% (CI: 24-28) and 29% (CI: [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38]). The highest proportion with very good or excellent health was among persons born in India at 62% (CI: 52-71).…”

Section: Overall Health and Risk Factors For Tb Reactivationmentioning

confidence: 99%

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Health insurance, healthcare utilization and language use among populations who experience risk for tuberculosis, California 2014–2017

2022

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Background California tuberculosis (TB) prevention goals include testing more than ten million at-risk Californians and treating two million infected with tuberculosis. Adequate health insurance and robust healthcare utilization are crucial to meeting these goals, but information on these factors for populations that experience risk for TB is limited. Methods We used data from the 2014–2017 California Health Interview Survey (n = 82,758), a population-based dual-frame telephone survey to calculate survey proportions and 95% confidence intervals (CI) stratified by country of birth, focusing on persons from countries of birth with the highest number of TB cases in California. Survey proportions for recent doctor’s visit, overall health, smoking, and diabetes were age-adjusted. Results Among 18–64 year-olds, 27% (CI: 25–30) of persons born in Mexico reported being uninsured in contrast with 3% (CI: 1–5) of persons born in India. Report of recent doctor’s visit was highest among persons born in the Philippines, 84% (CI: 80–89) and lowest among Chinese-born persons, 70% (CI: 63–76). Persons born in Mexico were more likely to report community clinics as their usual source of care than persons born in China, Vietnam, or the Philippines. Poverty was highest among Mexican-born persons, 56% (CI: 54–58) and lowest among Indian-born persons, 9% (CI: 5–13). Of adults with a medical visit in a non-English language, 96% (CI: 96–97) were non-U.S.-born, but only 42% (CI: 40–44) of non-U.S.-born persons had a visit in a non-English language. Discussion Many, though not all, of the populations that experience risk for TB had health insurance and used healthcare. We found key differences in usual source of care and language use by country of birth which should be considered when planning outreach to specific providers, clinic systems, insurers and communities for TB prevention and case-finding.

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Section: Healthcare Utilization and Barriers To Carementioning

confidence: 99%

Section: Overall Health and Risk Factors For Tb Reactivationmentioning

confidence: 99%

Health insurance, healthcare utilization and language use among populations who experience risk for tuberculosis, California 2014–2017

2022

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“…Immigrant women may have poorer access to maternal health care due to lack of insurance. Health insurance contributes to health care utilization, and disparities in health insurance status by nativity are well documented [14][15][16][17]. Exclusionary health coverage policies, such as Medicaid ineligibility for some immigrant groups, also limit access to care [18].…”

Section: Introductionmentioning

confidence: 99%

Utilization of Maternal Health Care Among Immigrant Mothers in New York City, 2016–2018

et al. 2021

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Immigrant women represent half of New York City (NYC) births, and some immigrant groups have elevated risk for poor maternal health outcomes. Disparities in health care utilization across the maternity care spectrum may contribute to differential maternal health outcomes. Data on immigrant maternal health utilization are under-explored in the literature. We conducted a cross-sectional analysis of the population-based NYC Pregnancy Risk Assessment Monitoring System survey, using 2016–2018 data linked to birth certificate variables, to explore self-reported utilization of preconception, prenatal, and postpartum health care and potential explanatory pathways. We stratified results by maternal nativity and, for immigrants, by years living in the US; geographic region of origin; and country of origin income grouping. Among immigrant women, 43% did not visit a health care provider in the year before pregnancy, compared to 27% of US-born women (risk difference [RD] = 0.16, 95% CI [0.13, 0.20]), 64% had no dental cleaning during pregnancy compared to 49% of US-born women (RD = 0.15, 95% CI [0.11, 0.18]), and 11% lost health insurance postpartum compared to 1% of US-born women (RD = 0.10, 95% CI [0.08, 0.11]). The largest disparities were among recent arrivals to the US and immigrants from countries in Central America, South America, South Asia, and sub-Saharan Africa. Utilization differences were partially explained by insurance type, paternal nativity, maternal education, and race and ethnicity. Disparities may be reduced by collaborating with community-based organizations in immigrant communities on strategies to improve utilization and by expanding health care access and eligibility for public health insurance coverage before and after pregnancy.

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“…Over the past decade, an increasingly diverse immigrant population has attained access to health care in the United States. 6 This, coupled with the rapid growth of electronic devices and toys using a wide array of button batteries, leads to new uncertainties in differentiating coins from batteries. This is reflected in publication trends displaying a spike in the volume of published medical literature regarding battery ingestion over the past decade, with a smaller proportion of total publications from the United States, signifying diversification of research.…”

mentioning

confidence: 99%

“…Successful identification of button batteries and subsequent rapid retrieval are critical in minimizing the severity of complications following ingestion. Over the past decade, an increasingly diverse immigrant population has attained access to health care in the United States 6 . This, coupled with the rapid growth of electronic devices and toys using a wide array of button batteries, leads to new uncertainties in differentiating coins from batteries.…”

mentioning

confidence: 99%

Urgency of Esophageal Foreign Body Removal: Differentiation Between Coins and Button Cell Batteries

Safavi

Brook

Sakai

et al. 2021

Otolaryngol.--head neck surg.

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Objective Coin-shaped button battery foreign bodies have a similar initial presentation to coin ingestion, but delayed retrieval of a battery from the esophagus can have devastating consequences. Variations in timing of retrieval for children with ingestion of coin foreign bodies have been reported. The study assesses the sensitivity and specificity of conventional and digital radiographs to differentiate button batteries from coin foreign bodies. Study Design 3B case control study. Study Setting Tertiary academic medical center. Methods A radiographic study of the 12 most common commercially available button batteries and 66 coins of varying international origins was performed. Foreign bodies were placed at the cervical esophagus of a cadaver, and anteroposterior (AP) and lateral conventional radiographs of the neck were obtained. Digital AP and lateral radiographs of standalone coins and batteries were also obtained. Images were blindly read by 2 otolaryngologists and 2 radiologists. Statistical analysis was performed to determine accuracy in identifying coins vs batteries. Results Using conventional radiographs to identify button batteries yielded a sensitivity of 0.88 and a specificity of 0.92 (positive predictive value [PPV] = 0.75, negative predictive value [NPV] = 0.97). Digital radiography yielded an overall sensitivity of 0.98 and specificity of 0.97 (PPV = 0.87, NPV = 0.99). Features of button batteries were only seen on AP conventional radiographs using reverse contrast. Conclusions Neither conventional nor digital radiographic imaging had perfect accuracy in identifying coins vs batteries. Features of common disc batteries were identified, which may aid in diagnosis. With potential devastating consequences from retained battery in the esophagus, emergent removal of any possible disc battery foreign body should be considered.

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Changes in Insurance Coverage and Healthcare Use Among Immigrants and US-Born Adults Following the Affordable Care Act

Cited by 9 publications

References 46 publications

Health insurance, healthcare utilization and language use among populations who experience risk for tuberculosis, California 2014–2017

Health insurance, healthcare utilization and language use among populations who experience risk for tuberculosis, California 2014–2017

Utilization of Maternal Health Care Among Immigrant Mothers in New York City, 2016–2018

Urgency of Esophageal Foreign Body Removal: Differentiation Between Coins and Button Cell Batteries

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