Objective: Hispanic immigrant populations vary greatly regarding demographic and economic factors based on their country of origin. Understanding the factors that influence healthcare disparities in the United States is essential to creating sustainable change in the healthcare system, and it begins with understanding the unique differences between the communities experiencing these disparities. Studies on emergency room utilization from non-native immigrants are limited in the current literature. This study sought to use country of origin as a predictor of emergency room usage from four Hispanic countries to demonstrate the disparities within the Hispanic community.

Methods: This cross-sectional study used the 2020 Medical Expenditure Panel Survey that collects information on utilization and expenditure of emergency room (ER) among foreign-born Hispanic adults aged 18 and above (N=1,838). We examined the association between four countries of origin and two outcomes, including the number of ER visits per person and average cost per visit. Survey-weighted multivariable regression models were conducted to evaluate how average cost varied by country of origin while considering demographics and socioeconomic factors including but not limited to insurance status, region, and language spoken.

Results: The results show that Dominicans spent $474.84 more than Mexicans per emergency room visit (p = .044). Dominicans spent the most out of the four countries, costing a total of $534.13 (p = .053). Average expenditures per emergency room visit for Mexicans were negatively associated with speaking a language other than English or Spanish and having a master’s degree (p = .029 and p = .003, respectively). For Puerto Ricans, average expenditures were negatively associated with low incomes (p = .044). Additionally, the average spending for Dominicans was negatively associated with living in the Midwest and positively related to having a doctorate degree (p = .006 and p = .022, respectively). No variables were identified as a strong predictor of average emergency room expenditures for Cubans.

Conclusion: Unexpected costs that arise with emergency room visits can be taxing on individuals and their families, especially those experiencing financial distress to begin with. This study demonstrates intra-group disparities in emergency room costs among Hispanic populations from four countries. However, very few variables could predict the reason for these observed findings, which are largely misunderstood. Understanding the reasons for the increased costs accompanying specific populations when they receive emergency services is vital in guiding treatment and ensuring that patients are treated equitably. More research needs to be done on hispanic immigrants that recognizes country of origin as a contributing factor to the health care they receive in the United States. With more awareness of the disparities present between Hispanic immigrant populations, extra precautions can be taken to ensure patients are not being undertreated or overtreated and erase the gap in associated costs.