Dialysis Hospitalization Inequities by Hispanic Ethnicity and Immigration Status

J Health Care Poor Underserved. 2017;28(4):1509-1521. doi: 10.1353/hpu.2017.0130.

Abstract

Medicare provides access to chronic outpatient dialysis for most U.S. patients diagnosed with end-stage renal disease. However, many new and/or undocumented immigrants do not qualify due to lawful presence and work credit requirements. Medicare-ineligible dialysis patients often wait until their health is poor enough for admission to emergency room dialysis. We use University of New Mexico Hospital chart data from 2013-2016 for a case-control study measuring the likelihood of being admitted to an emergency room for dialysis among patients who use interpreters, which is employed as a proxy for new and undocumented immigrants, compared with other patients. We find Hispanic patients who use an interpreter are significantly more likely to be admitted to emergency rooms for dialysis compared with patients who did not use an interpreter. This study highlights the need for national, state, and local policies to address this inefficient and inequitable healthcare pattern resulting in unnecessary costs and suffering.

MeSH terms

  • Eligibility Determination / statistics & numerical data
  • Emergency Service, Hospital / statistics & numerical data
  • Emigration and Immigration / statistics & numerical data*
  • Healthcare Disparities / ethnology*
  • Hispanic or Latino / statistics & numerical data*
  • Hospitalization / statistics & numerical data*
  • Hospitals, University
  • Humans
  • Kidney Failure, Chronic / ethnology*
  • Kidney Failure, Chronic / therapy
  • Medicare / organization & administration
  • New Mexico
  • Renal Dialysis / statistics & numerical data*
  • Translating
  • Undocumented Immigrants / statistics & numerical data*
  • United States