{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:15:46Z","timestamp":1788221746927,"version":"build-2803163510"},"reference-count":17,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Operation Metro Surge, a joint initiative by the Department of Homeland Security and the United States Immigration and Customs Enforcement (ICE), significantly disrupted daily life in Minnesota. Despite numerous anecdotal reports, the impact and scale of this disruption to local health care systems had not been quantified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>An interrupted-time series analysis was used to assess the impact of ICE Metro Surge on missed appointments and reschedule requests in 2 hospital-based general pediatrics practices located on the Minneapolis and St Paul campuses of Minnesota\u2019s flagship pediatric hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>We identified a total of 15\u2009611 eligible appointments in the post\u2013Metro Surge period and 113\u2009934 in the pre\u2013Metro Surge period. The rate of missed appointments among Hispanic\/Latin\u00e9 patients increased by 51.2% during Metro Surge compared to the same time period (the first week of December to second week of February) in the prior 2 years (31.3% vs 20.7%; P\u2009&amp;lt;\u2009.001). Missed appointment rates increased by 80.4% among Spanish-speaking families (34.1% vs 18.9%, P\u2009&amp;lt;\u2009.001) and 53.1% among families with a need for interpretation (28.1% vs 18.4%, P\u2009&amp;lt;\u2009.001). During the Metro Surge period, reschedule requests for well-child visits increased 51% compared to previous years (P\u2009&amp;lt;\u2009.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Our findings demonstrate that Metro Surge decreased pediatric outpatient use in Minneapolis and St Paul, Minnesota. The observed decrease in outpatient care exceeded predicted outpatient care based on preexisting and seasonal trends in missed appointments and reschedule requests. The cumulative effect of this period of exacerbated health care disparities and delayed care may have long-term impacts on child health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2026-076315","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:03:11Z","timestamp":1785974591000},"source":"Crossref","is-referenced-by-count":0,"title":["Pediatric Outpatient Care After Operation Metro Surge in Minneapolis"],"prefix":"10.1542","volume":"158","author":[{"given":"Asitha D. L.","family":"Jayawardena","sequence":"first","affiliation":[{"name":"1Ears, Nose, and Throat & Facial Plastic Surgery, Children\u2019s Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Fate","sequence":"additional","affiliation":[{"name":"2Pediatrics, Children\u2019s Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul","family":"Abdi","sequence":"additional","affiliation":[{"name":"2Pediatrics, Children\u2019s Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine A.","family":"Brunsberg","sequence":"additional","affiliation":[{"name":"2Pediatrics, Children\u2019s Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda J.","family":"Nickel","sequence":"additional","affiliation":[{"name":"3Research Institute, Children\u2019s Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"issue":"10","key":"2026083119571136400_r1","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1001\/jama.2026.1067","article-title":"US Patients Getting ICEd-Out of Health Care","volume":"335","author":"Rubin","year":"2026","journal-title":"JAMA."},{"issue":"9","key":"2026083119571136400_r2","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1056\/NEJMc2601288","article-title":"We Do Care","volume":"394","author":"Trappey","year":"2026","journal-title":"N Engl J Med."},{"key":"2026083119571136400_r3","doi-asserted-by":"crossref","first-page":"s366","DOI":"10.1136\/bmj.s366","article-title":"Fear of immigration enforcement is driving a public health crisis in 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care","volume":"22","author":"Alang","year":"2021","journal-title":"Prev Med Rep."},{"issue":"14","key":"2026083119571136400_r10","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1056\/NEJMp2601176","article-title":"Effects of Pervasive Immigration Enforcement on Children\u2019s Health","volume":"394","author":"Patel","year":"2026","journal-title":"N Engl J Med."},{"issue":"1","key":"2026083119571136400_r11","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s12874-021-01235-8","article-title":"Interrupted time series analysis using autoregressive integrated moving average (ARIMA) models: a guide for evaluating large-scale health interventions","volume":"21","author":"Schaffer","year":"2021","journal-title":"BMC Med Res Methodol."},{"issue":"11","key":"2026083119571136400_r12","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1056\/NEJMp2516715","article-title":"Health Consequences of Immigration Enforcement in U.S. Communities","volume":"394","author":"Arguello Belli","year":"2026","journal-title":"N Engl J Med."},{"key":"2026083119571136400_r13","article-title":"Somalis in Minnesota Are Feeling Fear This Ramadan Instead of Joy","author":"Rao","journal-title":"New York Times."},{"key":"2026083119571136400_r14","article-title":"Why Minnesota Matters More Than Iran for America\u2019s Future","author":"Friedman","journal-title":"New York Times."},{"key":"2026083119571136400_r15","article-title":"Somalis Fled Civil War and Built a Community. 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