Impact of a Case Management Program On Immigrants\u27 Health Status and Access to Care

In the United States (U.S.), immigrants are among the fastest growing populations of all communities. Today, they comprise approximately 11% of the total U.S. population. Forty-three percent of immigrants are without insurance. They are also associated with higher numbers of untreated medical conditions, fewer interactions with the health care system, and receiving health care through emergency departments (ER). The consequences of these practices include increases in health care costs, changes from preventive care to emergency treatment, delays in identifying illnesses until later, and higher disease prevalence. Case managers are frequently faced with immigrants\u27 concerns regarding access to care and prevention of illness in the community. They respond by implementing community programs. The process involves evaluating the effectiveness of the program. At the Immigration Outreach Service Center (IOSC), a study was completed to evaluate the effects of a case management program to a group of immigrants. Findings will help establish a program that improves immigrant\u27s health status, and increases access to health care services. During a three month period, a health clinic provided health education on disease prevention, access to health care services, and evaluated health services provided to meet immigrants\u27 needs. A systematic assessment and literature review of immigrants in the U.S. gathered information and identified the community\u27s health needs. Project sponsors, stakeholders, resources, funding sources, goals, objectives, mission, vision statements, and outcomes were identified. The logic model and The Public Health Nursing Practice Model served as a guide to accomplish the outcomes. To ensure patient\u27s protection, the IRB process was completed and approved. Data from 72 adult immigrants ages 18 and above were collected from visit records, self report scales, health history questionnaires, and surveys. A quantitative, comparison group, post-test design analyzed measure of health care access and health status. Descriptive analyses of averages and percentages characterized the study participants. Clients\u27 well-being was measured through The Ryff and Reyes Scale of Psychological Well-Being (RPWB). Statistical Package for the Social Sciences (SPSS) software organized, searched, and retrieved the collected data. The variables, subjects\u27 self reports of reduced number of visits to the ER, improved functional status, quality of life, knowledge of disease, clients\u27 demographics, age, ethnicity, cultural beliefs, health status, barriers to access to care, number of services, referrals, length of time in the program, use of health care facilities, resources, and the RPWB were measured