A Reversed Trend: Care for Limited English Proficiency Patients in the Pediatric Emergency Department

趋势逆转:儿科急诊科对英语能力有限的患者的护理

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Abstract

OBJECTIVES: Previous studies in pediatric emergency departments (EDs) showed patients with limited English proficiency (LEP) had gaps in care compared with English-speaking patients. In 2010, the Joint Commission released patient-centered communication standards addressing these gaps. We evaluate the current care of LEP patients in the Children's Healthcare of Atlanta (CHOA) EDs. METHODS: This was a retrospective cohort study of patients <18 years that presented to our EDs in 2016. Length of stay (LOS), change in triage status, return-visit rates, and hospital disposition were compared between patients who requested an interpreter and those who did not. RESULTS: The population included 152,945 patients from 232,787 ED encounters in 2016. Interpreters were requested for 12.1% of encounters. For ED LOS, a model-adjusted difference of 0.77% was found between interpreter groups. For change in triage status, adjusted odds were 7% higher in the interpreter requested cohort. For ED readmission within 7 days, adjusted odds were 3% higher in the interpreter requested cohort. These effect sizes are small (ES < 0.2). CONCLUSIONS: Our study showed low ES of the differences in ED metrics between LEP and English-speaking patients, suggesting little clinical difference between the two groups. The impact of this improvement should be further studied.

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