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Medical Care Research and Review
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Review: Immigrants and Health Care Access, Quality, and Cost

Kathryn Pitkin Derose

RAND Corporation, Santa Monica, CA

Benjamin W. Bahney

RAND Corporation, Santa Monica, CA

Nicole Lurie

RAND Corporation, Santa Monica, CA

José J. Escarce

University of California, Los Angeles, RAND Corporation, Santa Monica, CA

Inadequate access and poor quality care for immigrants could have serious consequences for their health and that of the overall U.S. population. The authors conducted a systematic search for post-1996, population-based studies of immigrants and health care. Of the 1,559 articles identified, 67 met study criteria of which 77% examined access, 27% quality, and 6% cost. Noncitizens and their children were less likely to have health insurance and a regular source of care and had lower use than the U.S. born. The foreign born or non-English speakers were less satisfied and reported lower ratings and more discrimination. Immigrants incurred lower costs than the U.S. born, except emergency department expenditures for immigrant children. Policy solutions are needed to improve health care for immigrants and their children. Research is needed to elucidate immigrants' nonfinancial barriers, receipt of specific processes of care, cost of care, and health care experiences in nontraditional U.S. destinations.

Key Words: immigrants • limited English proficiency • access • quality • cost

This version was published on August 1, 2009

Medical Care Research and Review, Vol. 66, No. 4, 355-408 (2009)
DOI: 10.1177/1077558708330425


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