Increased immigration enforcement is associated with “sharp, persistent” drops in emergency department visits among patients born outside the U.S., but an increase in inpatient admissions rates, a recent study found.
The study, published Oct. 5 in JAMA Network Open, analyzed electronic health records for adult patients at three safety-net hospital emergency and inpatient departments in Los Angeles County, where an estimated 10% of the population is undocumented and where well-publicized immigration raids took place in 2025. The study analyzed the change in encounters after increased immigration enforcement and anti-immigrant rhetoric in 2025. Researchers compared estimated weekly ED encounters and inpatient admission rates between June 6, 2024 and June 4, 2025, and June 5, 2025 to October 15, 2025.
Here are four key findings.
1. Before increased enforcement, the hospitals had a mean of 1,943 weekly ED visits for U.S.-born patients, 1,301 for Mexican-born patients, 850 for Central or South American-born patients and 216 for Asian-born patients. After increased enforcement, there was no change in ED visits for U.S.-born patients, but a sharp decrease of visits for those born outside the U.S.
2. Mexican-born patients had the largest drop, with 177 fewer weekly visits, followed by Central or South American-born patients and Asian-born patients. Visits remained below preenforcement levels 12 weeks after enforcement increased.
3. Inpatient admission rates, including transfers to other hospitals had a mean of 7.6% for U.S.-born, 20.3% for Mexican-born, and 16.1% for Central and South American–born patients prior to increased enforcement. After enforcement, inpatient admission rates rose for those born outside the U.S., but had little change for U.S. citizens.
4. Central or South American-born patients had the highest increase in admission rates, rising 5.1 percentage points, followed by Mexican-born patients at 4.8 percentage points and Asian-born at 2.5 percentage points.
“While ED utilization was lower throughout our study, the magnitude of the difference halved from a more-than-20% reduction in the first 4 weeks to a 10% reduction in visits by the end of our study period,” the study authors wrote. “In contrast to lower ED utilization, higher inpatient admission rates likely signal that patients who presented to the ED had higher acuity, consistent with delayed care-seeking or fewer nonurgent ED visits, bolstering inpatient admissions rates to reflect a higher number of acute visits.”
