Premium
Influence of language barriers on outcomes of hospital care for general medicine inpatients
Author(s) -
Karliner Leah S.,
Kim Sue E.,
Meltzer David O.,
Auerbach Andrew D.
Publication year - 2010
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.658
Subject(s) - medicine , odds ratio , odds , hospital medicine , confidence interval , socioeconomic status , observational study , language barrier , family medicine , emergency medicine , demography , logistic regression , population , environmental health , linguistics , philosophy , sociology
BACKGROUND: Few studies have examined whether patients with language barriers receive worse hospital care in terms of quality or efficiency. OBJECTIVE: To examine whether patients' primary language influences hospital outcomes. DESIGN AND SETTING: Observational cohort of urban university hospital general medical admissions between July 1, 2001 to June 30, 2003. PATIENTS: Eighteen years old or older whose hospital data included information on their primary language, specifically English, Russian, Spanish or Chinese. MEASUREMENTS: Hospital costs, length of stay (LOS), and odds for 30‐day readmission or 30‐day mortality. RESULTS: Of 7023 admitted patients, 84% spoke English, 8% spoke Chinese, 4% Russian and 4% Spanish. In multivariable models, non‐English and English speakers had statistically similar total cost, LOS, and odds for mortality. However, non‐English speakers had higher adjusted odds of readmission (odds ratio [OR], 1.3; 95% confidence interval [CI], 1.0‐1.7). Higher odds for readmission persisted for Chinese and Spanish speakers when compared to all English speakers (OR, 1.7; 95% CI, 1.2‐2.3 and OR, 1.5; 95% CI, 1.0‐2.3 respectively). CONCLUSIONS: After accounting for socioeconomic variables and comorbidities, non‐English speaking Latino and Chinese patients have higher risk for readmission. Whether language barriers produce differences in readmission or are a marker for less access to post‐hospital care remains unclear. Journal of Hospital Medicine 2010;5:276–282. © 2010 Society of Hospital Medicine.