Abstract
Documentation status is a well-recognized social determinant of health in the immigrant population of the United Sates. Lack of financial means and fear of legal repercussions can delay medical attention, limit treatment options, and decrease patient follow-up. This is reinforced by current government policies that limit financial assistance in emergency situations and deny coverage of preventative or follow-up care. Here we report a case of an otherwise healthy 24-year-old undocumented immigrant who presented to a rural United States emergency room with new-onset seizure, blurry vision, and headache. The patient was admitted to the neurosurgical service where he was diagnosed and treated for a symptomatic arachnoid cyst. Here we review current healthcare legislation that restricts access to preventative and follow-up healthcare in the United States. This case highlights the ways in which the undocumented immigrant patient population remains negatively impacted by these policies, often leading to late presentation and limited neurosurgical treatment options.
Highlights
Intracranial arachnoid cyst | neurosurgery | health services accessibility | social determinants of health | undocumented immigrant
Without legal access to health insurance, accessing health care in the US requires that undocumented immigrants personally absorb the costs of care or pursue free healthcare through either the emergency department or a free private clinic (3, 8)
These cysts are histopathologically benign, but they can cause dangerous increases in intracranial pressure that often requires neurosurgical management to resolve (10). This patient complied with federal guidelines, his neurosurgical care remained impacted by his inability to obtain health insurance and the threat of legal consequences related to his immigration status
Summary
Limits to Neurosurgical Care for an Undocumented Immigrant in the United States: A Case Report. This case highlights the ways in which the undocumented immigrant patient population remains negatively impacted by these policies, often leading to late presentation and limited neurosurgical treatment options. US health outcomes (measured in terms of mortality, the safety of care, and patient satisfaction) are not meaningfully improved by this spending, and are inferior to many highincome nations (1) To address these concerns, the Patient Protection and Affordable Care Act (PPACA, ACA, or \Obamacare"), enacted in 2010, greatly expanded coverage to many Americans. To provide care for undocumented immigrants, it is estimated to cost $10 billion per year, which accounts for 1.5% of total U.S medical cost (3, 4) It is necessary for the United States healthcare systems to collectively evaluate the way UIs access and receive care
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