THE EFFECTS OF CALIFORNIA PROPOSITION-187 ON OPHTHALMOLOGY CLINIC UTILIZATION AT AN INNER-CITY URBAN HOSPITAL

Purpose: To determine the effect on ophthalmology clinic utilization a t a major public inner-city hospital of California Proposition 187 and the debate surrounding its passage. Proposition 187 was a statewide r eferendum passed by 63% of the electorate in the November 1994 electio n that would restrict social services to undocumented immigrants and r equire providers to report them to immigration authorities. Methods: T he ophthalmology clinic volume at the Los Angeles County/University of Southern California Medical Center was analyzed from October 1 to Dec ember 31, 1993 and 1994. Results: New walk-in patients significantly d ecreased (P < 0.001) for a 2-month period around the election, but ret urned to baseline levels in December 1994. The new patient cancellatio n and no show rate was not affected. No change in return patient behav ior was noted for general and specialty clinics. Conclusions: Proposit ion 187 may have caused a statistically significant decrease in new wa lk-ins to the ophthalmology clinics during a 2-month period surroundin g 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 th e judicial system, and concern that providers would be required to rep ort undocumented immigrants to authorities was alleviated.