Can we talk? The association between language and preoperative wait times for gynecologic oncologic patients

Abstract

<h3>Objectives:</h3> The literature shows that non-English speakers have challenges in the perioperative setting when compared to English speaking patients. There is a lack of research within the field of gynecologic oncology regarding how patients' preoperative wait time and preoperative experience is influenced by their primary spoken language. The purpose of this study is to compare perioperative wait times in gynecologic oncology for English and non-English speaking patients at large public and private institutions. <h3>Methods:</h3> This is a retrospective review of women who underwent elective surgery for a gynecologic malignancy at both a large public safety-net hospital or a large private hospital between January 2018 and September 2019. Data collection included demographic data, baseline health characteristics, pre-operative information including dates of outpatient visits and surgical date. Statistical analysis included two-tailed T tests and chi-square tests. <h3>Results:</h3> 211 charts were reviewed, with 184 patients included in the final analysis. Charlson comorbidity indices were similar for English and non-English speaking patients (p=0.39). The most common non-English spoken languages were Spanish (55%), Mandarin (8%), Cantonese (8%), Polish (7%), and Russian (4%). Overall, the mean wait time from booking appointment to surgery for English speaking patients was 25.5 days compared to 33.6 days in non-English speaking patients (p=0.12). The majority (90%) of the non-English speaking patients included in the analysis received their care at the public hospital (p<0.001). When the analysis was restricted to public hospital patients, mean wait times from booking appointment to surgery were 33.7 and 36.7 days for English and non-English speaking patients, respectively (p=0.7). At the private hospital, wait times from booking appointment to surgery were 19.0 and 14.7 days for English and non-English speaking patients, respectively (p=0.5). When comparing wait times for non-English speaking patients at the two institutions, patients waited significantly longer at the public hospital (p=0.008). <h3>Conclusions:</h3> Non-English speaking patients had an 8 day increase in perioperative wait times compared to English speaking patients. This increase is largely attributable to the increased wait time for all patients in the public hospital system when compared to the private hospital. Further investigation of the structural differences between the public and university hospital systems is warranted.