The American journal of emergency medicine
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Case Reports
Vogt-Koyanagi-Harada disease: presentation and implications in undocumented immigrants.
Vogt-Koyanagi-Harada syndrome is an autoimmune disease involving pigmented tissue in the eyes, auditory system, skin, and central nervous system. It often presents as bilateral chronic granulomatous panuveitis. We report the case of a 32-year-old immigrant who presented to the emergency department asking for a second opinion for loss of vision and progressive hearing loss. We also will discuss the issue limited access to health care for a vulnerable population such as undocumented immigrants.
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Medicaid enrollees are disproportionately represented among patients with frequent Emergency Department (ED) visits, yet prior studies investigating frequent ED users have focused on patients with all insurance types. ⋯ One out of 8 Medicaid enrollees who visited the ED had ≥4 visits in a year. Efforts to reduce frequent ED use should focus on reducing barriers to accessing primary care. More tailored interventions are needed to meet the complex needs of adults with ≥18 visits per year.