Do Immigrants Use Emergency Departments for Preventable Visits?

September 4, 2017 | Press Releases & Announcements

Dr. Jim Stimpson

Dr. Jim Stimpson

Dr. Jim Stimpson, Associate Dean for Academic Affairs at the CUNY Graduate School of Public Health and Health Policy (CUNY SPH) and colleagues examined the differences in using the emergency department for preventable visits between noncitizens, naturalized and US-born citizens in the United States. The findings were published in the American Journal of Emergency Medicine.

Dr. Stimpson explains, “The perception of emergency department (ED) overcrowding by immigrants has been a long-debated political issue. Reducing preventable emergency department visits is critical to controlling health expenditures and improving the overall health of the population. However, immigrants in the United States have limited access to health insurance and primary care compared to US natives.”

The research team linked the 2008-2012 Medical Expenditure Panel Survey with National Health Interview Survey data to draw a nationally representative sample of U.S. adults. They used univariate analysis to describe the distribution of preventable emergency department visits identified by the Prevention Quality Indicators across immigration status. They also assessed the association between preventable emergency department visits and immigration status, controlling for demographics, socioeconomic status, health service utilization, and health status.

Of U.S. natives, 2.1% had any preventable emergency department visits within the past years as compared to 1.0% of noncitizens and 1.5% of naturalized citizens. Multivariate results also revealed that immigrants groups, both naturalized citizen and noncitizens, were significantly less likely than citizens of having preventable emergency department visits. Further stratified analysis by insurance status showed these differences were only significant among the uninsured and publicly insured groups. Race/ethnicity and health insurance explained about 68% of the difference in preventable emergency department service utilization between natives and noncitizens

The team concluded that there are differences in preventable emergency department visits across immigration status.

“We found that immigrant populations tended to visit the emergency department for routine care less often than US native populations. This finding not only contradicts the political perception that immigrants are responsible for overcrowded EDs, it is also consistent with other research that has found that immigrant populations have significantly lower utilization of healthcare than US native populations,” summarizes Dr. Stimpson.


Wang, Y., Wilson, F., Stimpson, J., Wang, H., Palm, D., Chen, B. and Chen, L. (2017). Fewer immigrants have preventable emergency department visits in the United States. The American Journal of Emergency Medicine.