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Impact of United States 2017 Immigration Policy changes on missed appointments at two Massachusetts Safety-Net Hospitals

Journal of Immigrant and Minority Health volume 24, pages 807–818 (2022)Cite this article

Abstract

Introduction

Studies have shown mixed findings regarding the impact of immigration policy changes on immigrants’ utilization of primary care.

Methods

We used a difference-in-differences analysis to compare changes in missed primary care appointments over time across two groups: patients who received care in Spanish, Portuguese, or Haitian Creole, and non-Hispanic, white patients who received care in English.

Results

After adjustment for age, sex, race, insurance, hospital system, and presence of chronic conditions, immigration policy changes were associated with an absolute increase in the missed appointment prevalence of 0.74 percentage points (95% confidence interval: 0.34, 1.15) among Spanish, Portuguese and Haitian-Creole speakers. We estimated that missed appointments due to immigration policy changes resulted in lost revenue of over $185,000.

Conclusions

We conclude that immigration policy changes were associated with a significant increase in missed appointments among patients who receive medical care in languages other than English.

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Funding

This study was funded by the Cambridge Health Alliance Foundation and the Pisacano Leadership Foundation of the American Board of Family Medicine.

Author information

Authors and Affiliations

  1. Department of Family Medicine, Cambridge Health Alliance, 1493 Cambridge St, 02139, Cambridge, MA, United States

    Lara Z. Jirmanus MD, MPH

  2. Boston University School of Public Health, Boston, MA, United States

    Lynsie Ranker MPH

  3. Institute for Community Health, Malden, MA, United States

    Sharon Touw MPH

  4. Cambridge Health Alliance, Cambridge, MA, United States

    Rumel Mahmood

  5. Boston Medical Center, Boston, MA, United States

    Sarah L. Kimball MD & Karen E. Lasser MD, MPH

  6. Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, United States

    Amresh Hanchate PhD

  7. Harvard Medical School, Boston, MA, United States

    Lara Z. Jirmanus MD, MPH

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  1. Lara Z. Jirmanus MD, MPH
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  2. Lynsie Ranker MPH
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  3. Sharon Touw MPH
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  4. Rumel Mahmood
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  7. Karen E. Lasser MD, MPH
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Correspondence to Lara Z. Jirmanus MD, MPH.

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Jirmanus, L.Z., Ranker, L., Touw, S. et al. Impact of United States 2017 Immigration Policy changes on missed appointments at two Massachusetts Safety-Net Hospitals. J Immigrant Minority Health 24, 807–818 (2022). https://doi.org/10.1007/s10903-022-01341-9

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  • DOI: https://doi.org/10.1007/s10903-022-01341-9

Keywords

  • Immigrants
  • Healthcare Access
  • Primary care
  • Immigration Policy
  • Fear
  • Missed appointments
  • Massachusetts
  • Limited English proficiency