Substandard medical care of detained immigrant children experiencing common acute illnesses
Evidence from a U.S. family immigration detention facility
Bibliographic Data
Purpose Access to timely, pediatric-specific medical care is critical for every acutely ill child to prevent complications, long-term disability and untimely death. This is particularly important in contexts such as immigration detention facilities, which pose unique risks to children. This study aims to analyze the quality of acute medical care of common childhood illnesses that was delivered in a family immigration detention facility in the US. Design/methodology/approach A retrospective observational study was conducted of 165 children who were detained at the Karnes Family Residential Facility from June 2018 to October 2020. Acute care visits completed at the facility were reviewed. Chart notes for three of the top six chief complaints (i.e. cough, fever and diarrhea) were analyzed for a series of quality measures derived from national clinical guidelines. Findings The analysis revealed significant deviations from clinical standards, including incomplete clinical assessment, a failure to determine a clinical diagnosis and inappropriate prescribing. These deviations were noted with alarming frequency, suggesting a systemic failure in adherence to standards of care. Social implications Detention is never in the best interest of the child and must end. However, as long as immigrant children remain detained in the USA, they must receive age-appropriate health care that meets quality standards. Critical review, external oversight and reforms of medical care in immigration detention are essential to ensure that children are protected from the preventable increased morbidity and mortality associated with this setting. Originality/value Ample research has documented the inadequacy of health care in US immigration detention for adults; however, empiric data on pediatric care in these facilities remain limited. To the best of the authors’ knowledge, this study is the first to examine pediatric acute care using primary data from children’s medical records
Acute care · Health care · Immigration · Immigration detention · Medical care · Observational study · Interpreting and Communication in Healthcare · Migration, Health and Trauma · Pediatric health and respiratory diseases
Research electronic data capture (Redcap)—A metadata-driven methodology and workflow process for providing translational research informatics support
The Redcap consortium
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| Citation velocity | historical |
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| Highly cited | No |