Association of Primary Language and Hospitalization for Ambulatory Care Sensitive Conditions

Bibliographic Data

ID9105019
AuthorsTimothy S Anderson (0000-0002-5384-275X, Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MA, corresponding author), Leah S Karliner (University of California, San Francisco), Leah Karliner (0000-0003-2204-5114, University of California, San Francisco), Grace A Lin (0000-0001-6498-641X, University of California, San Francisco)
Year2020
Volume58
Issue1
Pages45-51
Publication date2020-01-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001245
PMID31821245
OpenAlexW2995028198
LanguageEN
Citations received4
References cited29

BACKGROUND: Limited English proficiency is associated with decreased access to ambulatory care, however, it is unclear if this disparity leads to increased use of emergency departments (EDs) for low severity ambulatory care sensitive conditions (ACSCs). OBJECTIVE: We sought to determine the association between the patient's preferred language and hospital utilization for ACSCs. RESEARCH DESIGN: We conducted a retrospective cohort study of all ED visits in New Jersey in 2013 and 2014. The primary outcome was hospital admission for acute ACSCs, chronic ACSCs, and fractures (a nonambulatory care sensitive control condition). Secondary outcomes included intensive care unit (ICU) utilization and length of stay. Mixed-effect regression models estimated the association between preferred language (English vs. non-English) and study outcomes, controlling for demographics, comorbidities, and hospital characteristics. RESULTS: We examined 201,351 ED visits for acute ACSCs, 251,193 visits for chronic ACSCs, and 148,428 visits for fractures, of which 13.5%, 11.1%, and 9.9%, respectively, were by non-English speakers. In adjusted analyses, non-English speakers were less likely to be admitted for acute ACSCs [-3.1%; 95% confidence interval (CI), -3.6% to -2.5%] and chronic ACSCs (-2.3%; 95% CI, -2.8% to -1.7%) but not fractures (0.4%; 95% CI, -0.2% to 1.0%). Among hospitalized patients, non-English speakers were less likely to receive ICU services but had no difference in length of stay. CONCLUSIONS: These findings suggest non-English-speaking patients may seek ED care for lower acuity ACSCs than English-speaking patients. Efforts to decrease preventable ED and increase access to ambulatory care use should consider the needs of non-English-speaking patients

Acute care · Ambulatory · Ambulatory care · Confidence interval · Emergency department · Health care · Intensive care medicine · Intensive care unit · Limited English proficiency · Retrospective cohort study · Emergency and Acute Care Studies · Emergency Medicine · Hearing Impairment and Communication · Internal Medicine · Interpreting and Communication in Healthcare · Medicine · Nursing

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