Overuse of Health Services May Be a Myth

This week, at the annual meeting of the American Public Health Association in Denver, researchers analyzed survey data from California — investigating the concern that immigrants are a major drain on health care services.

“People looked at immigrants and undocumented workers and their use of emergency services and preventive care, and found that those groups are actually less likely than other groups to use health care services,” according to David Grant, director of the California Health Interview Survey.

“The data show [lower usage] of emergency services, as well as lower usage of preventive medicine, even among immigrants who have insurance,” he said.

That information flies in the face of the prevailing belief that because uninsured patients don’t get preventive care, they go to the emergency room for basic health care.

“That is not borne out by the data,” Grant said. Instead, he said, many immigrants don’t get any care — in clinics or in emergency rooms — until they become extremely ill. And in some cases, he said, it’s likely that, at that point, they might return to their country of origin to get health care.

The question is, Grant said, from public health and public cost points of view, is that good or bad?

“At some point it’s going to result in much higher costs,” he said, “because they don’t make it to the emergency room until there’s something serious and expensive. Higher utilization rates of preventive care would be a good thing, especially with highly contagious things like the flu.”

National health care reforms are more likely to affect native Californians, Grant said, since immigrants and undocumented workers haven’t used services as much.

“But this idea that somehow they’re a drain on health services, that doesn’t seem to be borne out by the data,” Grant said. “It’s true that sometimes the emergency rooms are crowded, and sometimes there are a lot of immigrants there. But it’s not a simple either/or proposition.”