Emergency Department Readmission for Early Pregnancy Concerns Among Patients Who Speak Spanish [ID: 1366721

Abstract

INTRODUCTION: The purpose of this study was to compare readmission rates for early pregnancy concerns in the emergency department (ED) among patients that speak English versus Spanish as their primary language. METHODS: From January 1, 2020 to June 1, 2021, we conducted a chart review to identify pregnant patients presenting to the ED using ICD-10 codes for pregnancy and first-trimester diagnoses (n=383). Charts were excluded if pregnancy was beyond 13 weeks or an ultrasound-confirmed ectopic pregnancy. Readmission was a separate ED encounter during the first trimester of that same pregnancy. Preventable readmission was one that could have been prevented if the patient had received correct counseling, diagnosis, or management at the index admission. Our primary outcome was frequency of ED readmission among English versus Spanish speakers. This protocol was approved for IRB exemption by the University of Texas. RESULTS: Threatened abortion was the most common diagnosis among both groups. Readmissions were more frequent among Spanish speakers (40% versus 26% [P=.01]). Preventable readmissions were more common among Spanish speakers (31% versus 25%). The majority of preventable readmissions (81%) among Spanish speakers could have been prevented if correct management was offered, compared to 25% in English speakers (P=.03). CONCLUSION: Spanish and English speakers present with similar types of early pregnancy concerns, but Spanish speakers are not offered management of early pregnancy concerns at the same frequency. Standardization of care for early pregnancy concerns in the ED may help reduce language-based disparities in quality and equity of care.