To evaluate the association of recent policy changes with emergency department (ED) visits among undocumented patients in Massachusetts and to assess the impact of preferred language on utilization patterns in the context of these changes.
Key Findings:
Total visits included were 357,643, with 10.3% having MHL/missing insurance.
ED visits among adults with MHL/missing insurance decreased by 11.2% from preperiod to postperiod (95% CI, 10.7%-11.7%).
Pediatric visits with MHL/missing insurance decreased by 13.4% during the same time frame (95% CI, 12.2%-14.7%).
Patients with Portuguese as a preferred language had the highest rates of MHL/missing insurance and showed a 17.2% decline in visits (95% CI, 15.6%-18.8%).
Interpretation:
Preferred language may not reliably indicate utilization patterns.
Limitations:
State-specific nature of Medicaid insurance products limits generalizability.
Results may be affected by other individuals using MHL, not just undocumented patients.
Temporal associations cannot establish causation.
Potential decline in visits may also be due to patients leaving the community.
Conclusion:
Future research must focus on accurate data collection while considering the ethical implications of care delivery.
