Texas medicine
Volume 103, Issue 4, 2007, Pages 54-58, 53

Care for immigrants with end-stage renal disease in Houston: a comparison of two practices. (Article)

Sheikh-Hamad D.* , Paiuk E. , Wright A.J. , Kleinmann C. , Khosla U. , Shandera W.X.
  • a Department of Medicine, Baylor College of Medicine, Houston, Texas, United States
  • b Department of Medicine, Baylor College of Medicine, Houston, Texas, United States
  • c Department of Medicine, Baylor College of Medicine, Houston, Texas, United States
  • d Department of Medicine, Baylor College of Medicine, Houston, Texas, United States
  • e Department of Medicine, Baylor College of Medicine, Houston, Texas, United States
  • f Department of Medicine, Baylor College of Medicine, Houston, Texas, United States

Abstract

In 1997, the practice for treating undocumented immigrant patients with end-stage renal disease (ESRD) at a Houston public hospital changed. In this study, we compare the two systems that evolved. Newly encountered immigrants with ESRD were provided only emergent dialysis, while patients previously on scheduled dialysis were "grandfathered in" and maintained on care equivalent to that provided to US citizens. Primary measures compared were patient utilization of hospital services, self-perceived satisfaction, and costs. Thirteen newly diagnosed emergent care patients were compared with 22 patients with unchanged levels of care. For the emergent group, patient utilization of beds and emergency room facilities was higher, patient satisfaction was lower for all but one index, and total costs of care were more than 3.7 times higher. Restricting care for undocumented immigrants with ESRD in our system resulted in greater utilization of hospital services, lower patient satisfaction, and increased cost.

Author Keywords

[No Keywords available]

Index Keywords

prospective study Cost benefit analysis economics community care Prospective Studies human middle aged comparative study Aged ethnology quality of life United States health care cost Health Care Costs Humans male female Renal Dialysis Article Retrospective Studies Emergency Medical Services adult Kidney Failure, Chronic migration legal aspect emergency health service renal replacement therapy Emigration and Immigration retrospective study Uncompensated Care chronic kidney failure cost-benefit analysis Texas
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-34249853695&partnerID=40&md5=50fdc2b22b8e60864be4747dab6915b1
ISSN: 00404470
Cited by: 38
Original Language: English