Health Status and Hospital Utilization of Recent Immigrants to New York City

Background. This paper examines hospital utilization, estimated hospital costs, and mortality rates for U.S.-born, foreign-born, and Puerto Rican-born persons residing in New York City. Methods. We conducted a multivariate regression analysis using New York City neighborhoods as the unit of analysis. We utilized data from the Statewide Planning and Research Cooperative System data set and from the 1997 Housing and Vacancy Survey. We also examined mortality rates using 1990 death certificate data and decennial census data. Results. The foreign-born are much less likely to be hospitalized for most major categories of illness and have lower mortality rates than either U.S.-born or Puerto Rican-born New Yorkers. The life expectancy at 1 year of age of the foreign-born is 4 years longer than for U.S.-born persons and 6 years longer than Puerto Rican-born persons. We estimate that the overall cost of providing hospital-based care to the foreign-born was $611 million dollars less than the cost of providing hospital-based care to an equivalent number of U.S.-born persons in 1996. Conclusion. The foreign-born in New York City appear to be healthier and consume fewer hospital resources than U.S.-born populations. It is possible that the cost of hospital utilization would be lower still if the foreign-born population had better access to ambulatory and preventive services.