Pediatric Outpatient Care After Operation Metro Surge in Minneapolis

Abstract

BACKGROUND Operation Metro Surge, a joint initiative by the Department of Homeland Security and the United States Immigration and Customs Enforcement (ICE), significantly disrupted daily life in Minnesota. Despite numerous anecdotal reports, the impact and scale of this disruption to local health care systems had not been quantified. METHODS An interrupted-time series analysis was used to assess the impact of ICE Metro Surge on missed appointments and reschedule requests in 2 hospital-based general pediatrics practices located on the Minneapolis and St Paul campuses of Minnesota’s flagship pediatric hospital. RESULTS We identified a total of 15 611 eligible appointments in the post–Metro Surge period and 113 934 in the pre–Metro Surge period. The rate of missed appointments among Hispanic/Latiné patients increased by 51.2% during Metro Surge compared to the same time period (the first week of December to second week of February) in the prior 2 years (31.3% vs 20.7%; P < .001). Missed appointment rates increased by 80.4% among Spanish-speaking families (34.1% vs 18.9%, P < .001) and 53.1% among families with a need for interpretation (28.1% vs 18.4%, P < .001). During the Metro Surge period, reschedule requests for well-child visits increased 51% compared to previous years (P < .001). CONCLUSIONS Our findings demonstrate that Metro Surge decreased pediatric outpatient use in Minneapolis and St Paul, Minnesota. The observed decrease in outpatient care exceeded predicted outpatient care based on preexisting and seasonal trends in missed appointments and reschedule requests. The cumulative effect of this period of exacerbated health care disparities and delayed care may have long-term impacts on child health.