Abstract
BackgroundLimited English proficiency is associated with health disparities and suboptimal health outcomes. Although Limited English proficiency is a barrier to effective health care, its association with inpatient health care utilization is unclear. The aim of this study was to examine the association between patients with limited English proficiency, and emergency department visits and hospital admissions.MethodsWe compared emergency department visits and hospitalizations in 2012 between patients requiring interpreter services and age-matched English-proficient patients (who did not require interpreters), in a retrospective cohort study of adult patients actively empanelled to a large primary health care network in a medium-sized United States city (n = 3,784).ResultsPatients who required interpreter services had significantly more Emergency Department visits (841 vs 620; P ≤ .001) and hospitalizations (408 vs 343; P ≤ .001) than patients who did not require interpreter services. On regression analysis the risk of a first Emergency Department visit was 60 % higher for patients requiring interpreter services than those who did not (unadjusted hazard ratio [HR], 1.6; 95 % confidence interval (CI), 1.4-1.9; P < .05), while that of a first hospitalization was 50 % higher (unadjusted HR, 1.5; 95 % CI, 1.2-1.8; P < .05). These findings remained significant after adjusting for age, sex, medical complexity, residency and outpatient health care utilization.ConclusionsPatients who required interpreter services had higher rates of inpatient health care utilization compared with patients who did not require an interpreter. Further research is required to understand factors associated with this utilization and to develop sociolinguistically tailored interventions to facilitate appropriate health care provision for this population.
Highlights
Limited English proficiency is associated with health disparities and suboptimal health outcomes
From the pool of eligible patients, we identified those who required interpreter services (IS) and the language spoken by using an institutional administrative database and the electronic medical record
Proportional hazard regression was used to assess the association between IS status and first Emergency department (ED) visit or hospitalization, and results were presented as hazard ratios (HRs) with 95 % Confidence Intervals (CI)
Summary
Limited English proficiency is associated with health disparities and suboptimal health outcomes. Limited English proficiency is a barrier to effective health care, its association with inpatient health care utilization is unclear. The aim of this study was to examine the association between patients with limited English proficiency, and emergency department visits and hospital admissions. Persons with LEP require medical interpreters or Limited English proficiency is an important mediator of health disparities, and has been linked to overall poor health and low quality of health care delivery [4]. Compared with patients who speak English well, LEP is associated with suboptimal disease-specific outcomes in mental health [9], asthma [10], diabetes mellitus [11], and heart failure [12]. LEP has been linked to patient dissatisfaction with care
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