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The purpose of the study is to compare access to healthcare, the use of healthcare services, and healthcare experiences for the undocumented Mexicans and other undocumented Latinos. In the wake of the policy debate over the immigrants’ 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 addition, the study is significant for evaluating healthcare experiences of undocumented immigrants in the United States, which acts as a framework for customizing public policy to either accommodate or restrict the immigrants’ use of public resources in the US. The specific issue that the research is aimed at addressing is threefold: to determine whether the 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 the critical review and identification of research limitations of the previous studies in order to support the specific aims of the research. In support of the research aims, Ortega et al (2007) points out that there is little empirical information provided in the previous literature regarding healthcare experiences for undocumented immigrants. Despite the fact that the studies have highlighted patterns of healthcare use by Mexican and Latino immigrants, there is little information about variations in terms of documentation status. In addition, the previous studies attempting to tackle the issue used relatively small samples and limited healthcare variables, resulting in inconclusive data. (Ortega et al, 2007, p. 2354). Similar to the past studies, this research aims at clarifying healthcare patterns, uses and experiences of immigrants according to documentation status and diversified healthcare measures, an aspect that has been ignored by the prior studies through the generalization of samples. In addition, the study is aimed at examining immigrants basing on their national origin and ethnicity. It is arguably evident that researchers described gaps in the available literature to support the need of the present study.
Theoretical Framework and Hypothesis
A significant flaw of the study is that researchers failed to outline a rationale for a conceptual framework. This is possibly because the study has been conducted with the aim of exploring aspects that the previous study has failed to consider. Researchers clearly stated the theoretical basis for hypothesis formulation. Ortega et al (2007) states that the CHIS offers unique and timely data on a large sample of the population 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 is no need to formulate a hypothesis and test it or to determine a casual relationship or inference between variables.
The study is descriptive with a clear definition of variables. Independent variables include ethnicity, immigration authorization status and national origin of participants. Dependent outcome variables/measures include the 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). An analysis has been conducted to ascertain a relationship between immigration authorization status and outcome measures among 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 are aimed at exploring patterns of access to healthcare, variations in the use of healthcare and experiences of the undocumented Mexicans and other undocumented Latinos in the United States. The study has 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). Data have been collected and analyzed to support the aims of the study. The potential threats to internal and external validity present in the study include the lack of the use of primary data. The study is somewhat analytical and does not entail a first-hand approach to gather information in order to document healthcare experiences of participants. Some elements of the research questions require more than just analyzing secondary data. For instance, the study should have used primary data sources obtained through interviews and questionnaires to document variations in healthcare experiences of participants.
The CHIS, which was a source of data for the study, made use of a random survey of households in California. The results were stratified to generate an adequate sample for the study. 42044 participants served to represent non-institutionalized households. They 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 is 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 addition, the chi-square and variance analysis were used for comparing healthcare access measures (usual source and care and difficulties in accessing basic care) and the use of healthcare services. A comparative analysis of healthcare experiences was also conducted. A multivariate analysis reported that the undocumented Mexicans had 1.6 less doctor visits with P<.01 in comparison with other US-born Mexicans. Statistical analysis techniques deployed by researchers are appropriate, because they attempt to offer descriptive and analytical data that can be used to answer the research questions. In addition, they are consistent with the level of measurement, and the size and method of sampling.
The research aims are threefold: to determine whether the 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 of the multivariate analysis are represented in tables, which is an appropriate method for representing comparative data. In addition, the descriptive statistics by race, national origin, and citizenship are tabled: this serves to compliment the presentation of results. Researchers could have also considered other graphical representation methods, such as graphs to indicate trends. Overall, there is an adequate representation of results, which takes into consideration the theoretical framework and the supporting literature to ensure that the specific research aims have been adequately presented.
The study results answer the research questions. Researchers presented their conclusions using data of the results. Limitations of the study are the use of secondary data sources, which imposes a significant question regarding its validity and reliability. Other limitations include the absence of objective health variables in the sense that access measures do not take into consideration the geographic availability of healthcare services. In addition, the study is limited by the fact that its scope is not beyond the state of California. In terms of the scope of the research, it is evident that the study findings are presented precisely within the scope of research parameters, implying that the study has not over-reached its goals. The study has significant implications, especially with regard to public policy-making in terms of healthcare. The research is of significant value for 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 there are reliable data sources and methods to explore elements of the research questions and to ascertain associations between participants’ demographics and healthcare outcomes measures.
The study is relevant to be put into practice, because it addresses issues that are pertinent to the society. The public debate regarding the immigrants’ use of public resources has been going on for quite a long time. Therefore, the study can be viewed as a clarification of pertinent issues affecting the public.
The study is feasible to be implemented, since it 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 its risks, since it offers a framework for policy analysis that policy makers can use to regulate the immigrants’ overuse of public resources by either restricting or increasing immigration authorization status among Latinos.
The aims of the study have been achieved basing on the validity and reliability of data and the methodology used in the study. The study has been aimed at evaluating the public view that immigrants overuse public resources. It affirmed otherwise, which increases policy options for public policy makers to regulate the use of public resources by immigrants by means of 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 has not used a hypothesis as a framework. The research has made significant contribution to the Health Services Research by exploring specific ethnicities of immigrants and their impacts and experiences concerning the US healthcare system.