The purpose of the study was to compare access to healthcare, use of healthcare services, and healthcare experiences for undocumented Mexicans and other undocumented Latinos. In the wake of policy debate over immigrant overuse of health services in the United States, the study is an important tool that policy makers can use to assess the impacts of immigrants on public services such as healthcare (Ortega, et al., 2007). In aIDition, the study is significant in evaluating the healthcare experiences of undocumented immigrants in the United States, which acts as a framework for customizing public policy to either accommodate or restrict immigrant use of public resources in the US. The specific aims that the research aimed at aIDress were threefold: to determine whether undocumented Mexicans and other undocumented Latinos use health services differently; whether they report different patterns of access; and whether they report different healthcare experiences.
The study by Ortega et al (2007) reviewed the focus of prior studies regarding the policy debate associated with undocumented immigrants. The literature review is organized in a logical sequence resulting in a critical review and identification of research limitations of previous studies in order to support the specific aims of the study. In support of the research aims proposed in the study, Ortega et al (2007) points out that there is little empirical information provided in previous literature regarding healthcare experiences for undocumented immigrants. Despite the fact that studies have highlighted patterns of healthcare use by Mexican and Latino immigrants, there is little information about the variations in terms of documentation status. In aIDition, past studies that have attempted to tackle the issue used relatively small samples and limited healthcare variables, resulting in inconclusive data. (Ortega et al, 2007, p. 2354). The relationship with past studies is that this research aim at clarifying healthcare patterns, uses and experiences of immigrants according to documentation status and diversified healthcare measures, an aspect that prior studies ignored through generalization of the samples. In aIDition, the study aimed at examining the immigrants basing on national origin and ethnicity. It is arguably evident that the researchers described the gaps in the available literature to support the need of the present study.
Theoretical Framework and Hypothesis
A significant flaw in the study is that the researchers failed to outline a rationale for the conceptual framework. This is possibly because the study was conducted with the aim of exploring aspects that previous study had failed to consider. The researchers clearly stated the theoretical basis for the hypothesis formulation. Ortega et al (2007) states that the CHIS offers a unique and timely data on a large sample of the populations basing on the assumption that there is little empirical information relating to healthcare access, patterns of use and healthcare experiences. Given the explorative and descriptive nature of the study, there was no need to formulate a hypothesis to be tested or to determine a casual relationship or inference between variables.
The study was descriptive with a clear definition of variables. The independent variables were ethnicity, immigration authorization status and national origin of participants. The dependent outcome variables/measures were use of physician and emergency department care, problems in obtaining basic care, having a usual source of care and three experiences with healthcare (Ortega, et al., 2007). Analysis was conducted to ascertain the relationship between immigration authorization status and the outcome measures among the participants. The research design can be argued to be implicit because the study simply aims at finding answers to the research questions by collecting and analyzing evidence. Overall, the research questions aimed at exploring the patterns of access to healthcare, variations in the use of healthcare and experiences among the undocumented Mexicans and other undocumented Latinos in the United States. The study used data secondary data sources from California Health Interview Survey, which is a random telephone survey of households in each county in California (Ortega, et al., 2007). The data collected was analyzed to support the aims of the study. The potential threats to the internal and external validity present in the study include lack of use of primary data. The study is somewhat analytical and does not entail a first-hand approach to gather information to document the healthcare experiences of the participants. Some elements of the research questions require more than just analysis of secondary data. For instance, the study should have used primary data sources through interviews and questionnaires to document the variation in the healthcare experiences of the participants.
The CHIS, which was the source of data for the study, made use of a random survey of the households in California. The results were stratified to generate adequate sample for the study. The 42044 participants served to represent the non-institutionalized households. The participants in the study were classified basing on ethnicity, immigration authorization status and national origin. Given the number of outcome measures and design, it is evident that the sample size of 40,044 participants was sufficient for the study.
Data analysis was done using commercially available software. The chi-squared test was used for describing the sample population in terms of health insurance, documentation status, demographics and ethnicity. In aIDition, chi-square and variance analysis were used in comparing healthcare access measures (usual source and care and difficulties in accessing basic care) and use of healthcare services. A comparative analysis on healthcare experiences was also conducted. A multivariate analysis reported that undocumented Mexicans had 1.6 less doctor visits with P<.01 when compared with other US-born Mexicans. The statistical analysis techniques deployed by the researchers are appropriate. This is because they attempt to offer descriptive and analytical data that can be used to answer the research questions. In aIDition, they are consistent with the level of measurement, the size and method of sampling.
The research aims were threefold: to determine whether undocumented Mexicans and other undocumented Latinos use health services differently; whether they report different patterns of access; and whether they report different healthcare experiences. The results for multivariate analysis were represented in tables, which is an appropriate method for representing comparative data. In aIDition, the descriptive statistics by race, national origin, and citizenship are tabled; this served to compliment the presentation of results. The researchers could have also considered other graphical representation methods such as graphs to indicate the trends. Overall, there is an adequate representation of results, which takes into consideration theoretical framework and the supporting literature to ensure that specific research aims are presented adequately.
The study results answer the research questions. The researchers presented their conclusions using data from the results. The limitations in the study were that it made use of secondary data sources, which imposes significant questions regarding its validity and reliability. Other limitations include absence of objective health variables in the sense that the access measures do not take into consideration the geographic availability of healthcare services. In aIDition, the study was limited by the fact its scope was not beyond the state of California. In terms of the scope of the research, it is evident that the study findings were presented precisely within the scope of research parameters, implying that the study did not over-reach its goals. The study has significant implications, especially with regard to public policy-making in terms of healthcare. The research is of significant value to public policy makers at the national level since it can be used as a framework for adopting either restrictive or accommodating public policies. A limitation is that the study does not provide recommendations for further research.
Research Utilization Implications
The study is of sufficient quality to meet the criterion of scientific merit. This is because the research used reliable data sources and methods to explore the elements of the research questions to ascertain the associations between participants demographics and healthcare outcomes measures.
The study is relevant to practice because it aIDresses issues that are pertinent to the society. The public debate regarding immigrants use of public resources has been going on for quite some time. Therefore, the study can be viewed as a clarification of pertinent issues affecting the public.
The study is feasible to implement since the study concludes that low rates of healthcare services usage by Mexican immigrants indicates that they do not overuse public resources such as healthcare. The study findings also indicate that the authorization of immigrant status is a significant determinant of access and patterns of healthcare use among Latinos.
The benefits of the study do not outweigh the risks since it offers a framework for policy analysis that policy makers can use to regulate immigrant overuse of public resources by either restricting or increasing immigration authorization status among Latinos.
The researchers achieved the aims of the study basing on the validity and reliability of the data and methodology used in the study. The study aimed at evaluating the public view that immigrants overuse public resources. The study affirmed otherwise, which increases the policy options for public policy makers to regulate the use public resources by immigrants using immigrant authorization. The study could be improved by providing an implicit overview of primary data collection methods and taking a stand on the public policy debate. This is not the case since the study did not make use of a hypothesis as a framework for the study. The research made significant contributions in Health Services Research by exploring specific ethnicities of immigrants and their impacts and experiences with the US healthcare system.
Ortega, A., Hai, F., Perez, V., Rizzo, J., Carter-Porkras, O., Wallace, S., et al. (2007). Health Care Access, Use of Services, and Experiences Among Undocumented Mexicans and Other Latinos. Arch Intern Med , 167 (21), 2354-2360.
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