Date of Award

5-2019

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Daryl Sieg

Keywords

uncompensated health care, emergency department overcrowding, undocumented immigrants, expanded Medicaid, Federally Qualified Health Centers

Abstract

Uncompensated health care and Emergency Department (ED) overcrowding are a national crisis in the United States, and uninsured patients are a major contributor. Undocumented Immigrants (UIs) are a large component of the uninsured patient population. The purpose of this study is to evaluate for efficacy and taxpayer value two large-scale potential solutions: Federally Qualified Health Centers (FQHCs), and expanded Medicaid. A brief analysis of smaller-scale solutions is also included. This study utilized a variety of key terms in electronic search databases such as CINAHL Complete, PubMed, and Google Scholar, and only articles published between 2014 and 2018 by peer-reviewed journals or gray literature (.gov) were included. Results were filtered for applicability, and studies were excluded that did not include data specifically about UIs. This scholarly project reveals several key points: 1.) UIs contribute more in tax dollars of all types to the US government than they draw out in benefits, rather than the large deficit that is published in the media; 2.) FQHCs provide acceptable primary care to UIs but there are too few of them, and UIs have little awareness of their existence and services; 3.) Expanded Medicaid in its current form will not solve both aspects - ED overcrowding and uncompensated health care - of the UI health care burden; 4.) The most cost effective and quality solutions will focus on shifting health care for UIs to primary care providers rather than EDs.

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