The effects of California Proposition 187 on ophthalmology clinic utilization at an inner-city urban hospital.
OBJECTIVE
To determine the effect on ophthalmology clinic utilization at a major public inner-city hospital of California Proposition 187 and the debate surrounding its passage. Proposition 187 was a statewide referendum passed by 63% of the electorate in the November 1994 election that would restrict social services to undocumented immigrants and require providers to report them to immigration authorities.


METHODS
The ophthalmology clinic volume at the Los Angeles County/ University of Southern California Medical Center was analyzed from October 1 to December 31, 1993 and 1994.


RESULTS
New walk-in patients significantly decreased (P < 0.001) for a 2-month period around the election, but returned to baseline levels in December 1994. The new patient cancellation and no show rate was not affected. No change in return patient behavior was noted for general and specialty clinics.


CONCLUSIONS
Proposition 187 may have caused a statistically significant decrease in new walk-ins to the ophthalmology clinics during a 2-month period surround the November 1994 election, but it had no measurable effect on other indicators of utilization. In addition, utilization rates returned to baseline after the implementation of Proposition 187 was stayed by the judicial system, and concern that providers would be required to report undocumented immigrants to authorities was alleviated.
Marx
J L
JL
Department of Ophthalmology, University of Southern California School of Medicine, Doheny Eye Institute, Los Angeles 90033, USA.
Thach
A B
AB
Grayson
G
G
Lowry
L P
LP
Lopez
P F
PF
Lee
P P
PP
D001071:Appointments and Schedules; D004641:Emigration and Immigration / Q000331:legislation & jurisprudence*; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006297:Health Services Accessibility / Q000191:economics / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D006766:Hospitals, County / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D015141:Los Angeles; D009885:Ophthalmology / Q000191:economics / Q000706:statistics & numerical data*; D010044:Outpatient Clinics, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D010349:Patient Compliance; D011057:Politics; D013219:State Government; D014504:Urban Health; D014600:Utilization Review