Ka Ming Ngai|Corita Grudzen|Roy Lee|Vicky Y. Tong|Lynne D. Richardson|Alicia Fernández
The Association Between Limited English Proficiency and Unplanned Emergency Department Revisit Within 72 Hours
Icahn School of Medicine at Mount Sinai|New York University|New York University|St. Francis College|Columbia University Irving Medical Center|Icahn School of Medicine at Mount Sinai|University of California, San Francisco
study objective language barriers known negatively affect many health outcomes among limited english proficiency patient populations little known quality care patients receive emergency department ed study seeks determine whether limited english proficiency patients experience different quality care englishspeaking patients ed using unplanned revisit within 72 hours surrogate quality indicator methods conducted retrospective cohort study urban adult ed 2012 total 41772 patients 56821 ed visits compared 2943 limited english proficiency patients 38829 englishspeaking patients presenting ed excluding patients psychiatric complaints altered mental status nonverbal states 4 ed visits 12 months two main outcomesthe risk inpatient admission ed risk unplanned ed revisit within 72 hourswere measured odds ratios generalized estimating equation multivariate models results limited english proficiency patients likely english speakers admitted 320 versus 272 odds ratio or120 95 confidence interval ci 111 130 association became nonsignificant adjustments or104 95 ci 095 115 included analysis ed revisit within 72 hours 32857 patients 45546 ed visits 42 patients n1380 least 1 unplanned revisit limited english proficiency patients likely english speakers unplanned revisit 50 versus 41 or119 95 ci 102 145 association persisted or124 95 ci 102 153 adjustment potential confounders including insurance status conclusion found difference hospital admission rates limited english proficiency patients englishspeaking patients yet limited english proficiency patients 24 likely unplanned ed revisit within 72 hours absolute difference 09 suggesting challenges ed quality care language barriers known negatively affect many health outcomes among limited english proficiency patient populations little known quality care patients receive emergency department ed study seeks determine whether limited english proficiency patients experience different quality care englishspeaking patients ed using unplanned revisit within 72 hours surrogate quality indicator conducted retrospective cohort study urban adult ed 2012 total 41772 patients 56821 ed visits compared 2943 limited english proficiency patients 38829 englishspeaking patients presenting ed excluding patients psychiatric complaints altered mental status nonverbal states 4 ed visits 12 months two main outcomesthe risk inpatient admission ed risk unplanned ed revisit within 72 hourswere measured odds ratios generalized estimating equation multivariate models limited english proficiency patients likely english speakers admitted 320 versus 272 odds ratio or120 95 confidence interval ci 111 130 association became nonsignificant adjustments or104 95 ci 095 115 included analysis ed revisit within 72 hours 32857 patients 45546 ed visits 42 patients n1380 least 1 unplanned revisit limited english proficiency patients likely english speakers unplanned revisit 50 versus 41 or119 95 ci 102 145 association persisted or124 95 ci 102 153 adjustment potential confounders including insurance status found difference hospital admission rates limited english proficiency patients englishspeaking patients yet limited english proficiency patients 24 likely unplanned ed revisit within 72 hours absolute difference 09 suggesting challenges ed quality care