IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0197282.html
   My bibliography  Save this article

Use of the emergency department by refugees under the Interim Federal Health Program: A health records review

Author

Listed:
  • Francis Bakewell
  • Sarah Addleman
  • Garth Dickinson
  • Venkatesh Thiruganasambandamoorthy

Abstract

Introduction: In June 2012, the federal government made cuts to the Interim Federal Health (IFH) Program that reduced or eliminated health insurance for refugee claimants in Canada. The purpose of this study was to examine the effect of the cuts on emergency department (ED) use among patients claiming IFH benefits. Methods: We conducted a health records review at two tertiary care EDs in Ottawa. We reviewed all ED visits where an IFH claim was made at triage, for 18 months before and 18 months after the changes to the program on June 30, 2012 (2011–2013). Claims made before and after the cuts were compared in terms of basic demographics, chief presenting complaints, acuity, diagnosis, presence of primary care, and financial status of the claim. Bivariate or multivariate logistic regression analysis was performed to yield odds ratios (OR) with 95% confidence intervals. Results: There were a total of 612 IFH claims made in the ED from 2011–2013. The demographic characteristics, acuity of presentation and discharge diagnoses were similar during both the before and after periods. Overall, 28.6% fewer claims were made under the IFH program after the cuts. Of the claims made, significantly more were rejected after the cuts than before (13.7% after vs. 3.9% before, adjusted OR 4.28, 95% CI: 2.18–8.40; p

Suggested Citation

  • Francis Bakewell & Sarah Addleman & Garth Dickinson & Venkatesh Thiruganasambandamoorthy, 2018. "Use of the emergency department by refugees under the Interim Federal Health Program: A health records review," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-8, May.
    • Handle: RePEc:plo:pone00:0197282
    DOI: 10.1371/journal.pone.0197282
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0197282
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0197282&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0197282?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Andrea Evans & Alexander Caudarella & Savithiri Ratnapalan & Kevin Chan, 2014. "The Cost and Impact of the Interim Federal Health Program Cuts on Child Refugees in Canada," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-4, May.
    2. Kayvan Bozorgmehr & Oliver Razum, 2015. "Effect of Restricting Access to Health Care on Health Expenditures among Asylum-Seekers and Refugees: A Quasi-Experimental Study in Germany, 1994–2013," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-22, July.
    3. Dranove, David, 1988. "Pricing by non-profit institutions : The case of hospital cost-shifting," Journal of Health Economics, Elsevier, vol. 7(1), pages 47-57, March.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Currie, Janet & Lin, Wanchuan & Zhang, Wei, 2011. "Patient knowledge and antibiotic abuse: Evidence from an audit study in China," Journal of Health Economics, Elsevier, vol. 30(5), pages 933-949.
    2. Christopher Hoag & Kamal Lamsal, 2014. "Nonprofit Firms in a Linear City with Nonnegative Profits," Working Papers 1403, Trinity College, Department of Economics.
    3. Yonas Semere Kidane & Sandra Ziegler & Verena Keck & Janine Benson-Martin & Albrecht Jahn & Temesghen Gebresilassie & Claudia Beiersmann, 2021. "Eritrean Refugees’ and Asylum-Seekers’ Attitude towards and Access to Oral Healthcare in Heidelberg, Germany: A Qualitative Study," IJERPH, MDPI, vol. 18(21), pages 1-20, November.
    4. Leonardo Mammana & Chiara Milani & Paola Bordin & Lorenzo Paglione & Chiara Salvia, 2020. "Health System Response during the European Refugee Crisis: Policy and Practice Analysis in Four Italian Regions," IJERPH, MDPI, vol. 17(15), pages 1-22, July.
    5. Michele Fioretti, 2022. "Caring or Pretending to Care? Social Impact, Firms' Objectives, and Welfare (former title: Social Responsibility and Firm's Objectives)," SciencePo Working papers hal-03393065, HAL.
    6. Woranan Witthayapipopsakul & Hathairat Kosiyaporn & Sonvanee Uansri & Rapeepong Suphanchaimat, 2022. "Effect of the Promulgation of the New Migrant’s Employment Law on Migrant Insurance Coverage in Thailand: An Interrupted Time Series Analysis, 2016–2018," IJERPH, MDPI, vol. 19(7), pages 1-12, April.
    7. Dor, Avi & Farley, Dean E., 1996. "Payment source and the cost of hospital care: Evidence from a multiproduct cost function with multiple payers," Journal of Health Economics, Elsevier, vol. 15(1), pages 1-21, February.
    8. Craig Garthwaite & Tal Gross & Matthew J. Notowidigdo, 2018. "Hospitals as Insurers of Last Resort," American Economic Journal: Applied Economics, American Economic Association, vol. 10(1), pages 1-39, January.
    9. Clara Pott & Tom Stargardt & Udo Schneider & Simon Frey, 2021. "Do discontinuities in marginal reimbursement affect inpatient psychiatric care in Germany?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(1), pages 101-114, February.
    10. Leemore Dafny & David Dranove, 2009. "Regulatory Exploitation and Management Changes: Upcoding in the Hospital Industry," Journal of Law and Economics, University of Chicago Press, vol. 52(2), pages 223-250, May.
    11. Frank, Richard G. & Glazer, Jacob & McGuire, Thomas G., 2000. "Measuring adverse selection in managed health care," Journal of Health Economics, Elsevier, vol. 19(6), pages 829-854, November.
    12. Yves Jackson & Adeline Paignon & Hans Wolff & Noelia Delicado, 2018. "Health of undocumented migrants in primary care in Switzerland," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-13, July.
    13. Saleh Aljadeeah & Veronika J. Wirtz & Eckhard Nagel, 2021. "Barriers to Accessing Medicines among Syrian Asylum Seekers and Refugees in a German Federal State," IJERPH, MDPI, vol. 18(2), pages 1-16, January.
    14. Lukas Kratzsch & Kayvan Bozorgmehr & Joachim Szecsenyi & Stefan Nöst, 2022. "Health Status and Access to Healthcare for Uninsured Migrants in Germany: A Qualitative Study on the Involvement of Public Authorities in Nine Cities," IJERPH, MDPI, vol. 19(11), pages 1-18, May.
    15. Calem, Paul S. & Dor, Avi & Rizzo, John A., 1999. "The welfare effects of mergers in the hospital industry," Journal of Economics and Business, Elsevier, vol. 51(3), pages 197-213, May.
    16. Daniel Kessler & Mark McClellan, 2001. "The Effects of Hospital Ownership on Medical Productivity," NBER Working Papers 8537, National Bureau of Economic Research, Inc.
    17. Shriver, Scott K. & Srinivasan, V. Seenu, 2011. "What If Marketers Put Their Customers ahead of Profits?," Research Papers 2091, Stanford University, Graduate School of Business.
    18. Lakdawalla, Darius & Philipson, Tomas, 2006. "The nonprofit sector and industry performance," Journal of Public Economics, Elsevier, vol. 90(8-9), pages 1681-1698, September.
    19. Currie, Janet & Gruber, Jonathan, 2001. "Public health insurance and medical treatment: the equalizing impact of the Medicaid expansions," Journal of Public Economics, Elsevier, vol. 82(1), pages 63-89, October.
    20. Gottlieb, Nora & Schülle, Mirjam, 2021. "An overview of health policies for asylum-seekers in Germany," Health Policy, Elsevier, vol. 125(1), pages 115-121.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0197282. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.