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

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.

Keywords: Fear; Healthcare Access; Immigrants; Immigration Policy; Limited English proficiency; Massachusetts; Missed appointments; Primary care.