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Health Equity. 2019 May 2;3(1):186-192. doi: 10.1089/heq.2018.0071. eCollection 2019.

Barriers to the Right to Health Among Patients of a Public Emergency Department After Implementation of the Affordable Care Act.

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1
Department of Emergency Medicine, Olive View-UCLA Medical Center, Sylmar, California.

Abstract

Purpose: Emergency physicians are witnesses to the impact of socioeconomic determinants of health on physical and psychiatric illness. Understanding structural barriers to the right to health (RTH) serves as a foundation for interventions to promote health equity. This study was performed to determine self-described barriers to fulfillment of the RTH among a public emergency department (ED) patient population. Methods: A convenience sample survey between June and August 2014 of 200 patients in public ED assessing demographic characteristics and desired assistance with 36 barriers to fulfillment of the RTH. Results: There was a high demand for specialty care (91%, 182/200), access to primary care (87.5%, 175/200), and access to health insurance (86%, 172/200). Undocumented residents were significantly more likely to cite health insurance as the most important area for assistance (p=0.04). Conclusion: Despite implementation of Affordable Care Act, access to health care and insurance were still perceived as the most important barriers among underserved patient populations, particularly undocumented groups.

KEYWORDS:

ACA; Affordable Care Act; health care disparities; immigrant; insurance; right to health

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