142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

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Tracking medical repatriations to Mexico: Experiences from the field

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014

John Sullivan, MSW , School of Social Work, National Autonomous University of Mexico, Mexico City, Mexico
Carol Baldwin, PhD, RN, CT, AHN-BC, FAAN , College of Health Solutions, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
Luis E. Zayas, PhD , School of Social Work, Arizona State University, Phoenix, AZ
Medical repatriations of undocumented and uninsured patients with chronic illnesses or catastrophic injuries initiated by American hospitals to Mexico have ramifications for patients and their families. Locating these patients after repatriation is challenging albeit critical to understanding this process and its impact. This report, part of a larger ongoing project, describes participant recruitment efforts with state actors and non-governmental organizations in Mexico that could have encounters with repatriated patients.

Following purposeful snowball sampling, contact was established with 5 national NGOs offering migrant services, governmental migrant service offices and hospitals in six states (and DF). Over 5 months, informal interviews and correspondence with health professionals, NGOs, and governmental staff were recorded in field-notes. To map the social and bureaucratic landscape, data was analyzed qualitatively.  Early findings suggest recruitment through governmental offices and hospitals yield more participants (6 cases) compared to NGOs. Efforts with NGOs have yielded no participants. Government agencies encounter patients seeking assistance post-repatriation or when Mexican consulates aide with transit visas for patients facing repatriation. Recruitment challenges include little follow-up by American hospitals, no tracking by U.S. authorities, and no patient registry. To overcome challenges, affiliations with a university and NGO were leveraged.

Few Mexican officials and healthcare professionals are knowledgeable of medical repatriations and have contact with patients pre/post-repatriation. Nescience of patients' repatriation histories may negatively affect treatment and wellbeing. American hospitals offer minimal coordination with Mexican institutions. Non-involvement by U.S. authorities to track repatriations hinders researchers and policy-makers in assessing the scope and impact of repatriations.

Learning Areas:

Administration, management, leadership
Chronic disease management and prevention
Diversity and culture
Ethics, professional and legal requirements
Public health or related laws, regulations, standards, or guidelines
Public health or related research

Learning Objectives:
Explain the medical repatriation process of undocumented and uninsured patients from U.S. hospitals to Mexico Describe the process of mapping the scope of medical repatriations to Mexico and tracking patient encounters with Mexican state and civil agencies Discuss alternative recruitment strategies for tracking repatriated patients and other binational populations in Mexico

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As a Fulbright research scholar, I have been carrying out field work in Mexico for the past 5 months, researching the practice of medical repatriations of chronically ill or injured undocumented patients to Mexico. I have authored a peer-reviewed commentary,"Passport biopsies: Hospital deportations and implications for social work", which was published in the journal Social Work in 2013. My research interests include assessing the impact of repatriations on patient health and their families.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.