Bolstering Immigrant Health Care

Imagine living without medical insurance in a health care community that, for the most part, doesnt speak your language. According to a study by the national Urgent Matters group released by the Northern Queens Health Coalition, this is only part of the problem plaguing not only the Queens health care system, but also the people it was designed to serve. In Queens, 21.3 percent of the population has no medical insurance and over half of the population speaks a language other than English.
All over the country, hospitals, health centers, public health departments and physicians offices are in crisis. Queens in particular has complex health care needs because of the ethnic, racial and linguistic diversity. New community residents often lack information about facilities that offer a safety net for the uninsured or those with an inability to pay for medical services out of pocket. Some groups are uncomfortable relying on government services such as Medicaid and choose to forgo care until absolutely necessary and thus end up in emergency rooms for non-emergent conditions.
"Emergency rooms have increasingly become a last resort," said Marsha Regenstein, senior advisor of the safety-net assessment team at Urgent Matters, "because it is the one place that people know they can get care 24 hours per day, seven days per week. As such, these ERs are increasingly overcrowded as more people with and without insurance turn to them for care. The consequences of the crowding are long waits, ambulances being forced to bypass the nearest hospital in favor of a less crowded one and patients on gurneys in the hallways waiting for a hospital bed."
These are not the only difficulties. Despite efforts to serve everyone, health care providers still struggle to provide care that is appropriately tailored to meet the needs of an ethnically diverse population. Elmhurst Hospital is just one of the facilities that strives to meet demands for interpreter services. Many people are only comfortable seeking care from medical providers of their own ethnicity.
The study did stress that there are organizations, such as the Nigerian Nurses Association, that are actively involved in facilitating access to health care for uninsured residents through health fairs, health care seminars and outreach programs. The Queens Health Network, made up of Elmhurst Hospital Center, Queens Hospital Center and 22 ambulatory centers, is also instrumental in disseminating information.
"We also found that residents still had a difficult time accessing some of the care they needed," said Holly Mead, a member of the Center for Health Services Research at George Washington University, which analyzed the Urgent Matters data. "The most significant problems reported were still a lack of culturally-friendly care, language barriers and a mixed perception of the availability of care."
One unique step that has been taken by the Queens Health Network is the implementation of a pilot program of $6.50 "smart cards," photo identification cards that contain a computer chip that holds information about patients medications, allergies, recent lab tests and results. When swiped through an inexpensive reader at a hospital, the patients records are quickly available in English to a doctor.
"Our patient population speaks about 127 different languages," said Pete Velez, senior vice president of Queens Health Network. "The problem was getting immediate information about medications and medical records once they have come to us."
According to Velez, the cards empower patients by giving them the freedom to determine how their own medical records will be managed and help sidestep translation issues.
"The issue of language and patient records such as medication and allergies are no longer a problem with many of our patients," he said.