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

• Type of Material: Article
• Authors: David Greenky, Emory University; Alyssa Levine, Emory University; Scott E. Gillespie, Emory University; Brittany Murray, Emory University
• Language: English
• Date: 2019-01-01
• Publisher: Hindawi
• Publication Version: Final Published Version
• Copyright Statement: © 2019 David Greenky et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1155/2019/4832045
• Title of Journal or Parent Work: Emergency Medicine International
• ISSN: 2090-2840
• Volume: 2019
• Start Page: 4832045
• End Page: 4832045
• Grant/Funding Information: This article published with support from Emory Libraries' Open Access Publishing Fund.; Emory University Department of Pediatrics Fellow and Resident Research Fund Grant of $1750 was used to support the statistical analysis [Children’s Healthcare of Atlanta/Emory University School of Medicine].
• Keywords: Science & Technology; Life Sciences & Biomedicine; Emergency Medicine
• Research Categories: Health Sciences, Health Care Management; Health Sciences, General

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.