Professional Language Interpretation and Inpatient Length of Stay and Readmission Rates

Lindholm, Mary; Hargraves, J. Lee; Ferguson, Warren J.; Reed, George W.

doi:10.1007/s11606-012-2041-5

Cited by 216 publications

(158 citation statements)

References 12 publications

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“…Five prior studies have analyzed the outcomes of LEP hospitalized patients compared to English speakers, but only two of these studies examined the impact of interpreter use with conflicting results. [12][13][14][15][16] The first study found no difference in LOS and 3-month ED utilization nor readmission rates with data from a large urban public hospital. 14 The second study found that the use of professional interpretation at admission or both admission and discharge was associated with an increased LOS and decreased readmission rates compared to those LEP patients without professional interpretation.…”

Section: Introductionmentioning

confidence: 97%

“…[7][8][9][10] Most studies to date have focused on the impact of interpreters in the outpatient and emergency department (ED) settings. 11,12 Few studies have explored the relationship between in-hospital physician use of interpreters and patient outcomes measured by length of stay (LOS) and readmission rates. Five prior studies have analyzed the outcomes of LEP hospitalized patients compared to English speakers, but only two of these studies examined the impact of interpreter use with conflicting results.…”

Section: Introductionmentioning

confidence: 99%

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Use of Interpreters by Physicians for Hospitalized Limited English Proficient Patients and Its Impact on Patient Outcomes

et al. 2015

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BACKGROUND: Few studies have examined the impact of inpatient interpreter use for limited English proficient (LEP) patients on length of stay (LOS), 30-day post discharge emergency department (ED) visits and 30-day hospital readmission rates for LEP patients. METHODS: A retrospective cohort analysis was conducted of all hospitalized patients admitted to the general medicine service at a large academic center. For patients self-reported as LEP, use of interpreters during each episode of hospitalization was categorized as: 1) interpreter used by non-MD (i.e., nurse); 2) interpreter used by a nonHospitalist MD; 3) interpreter used by Hospitalist; and 4) no interpreter used during hospitalization. We examined the association of English proficiency and interpreter use on outcomes utilizing Poisson and logistic regression models. RESULTS: Of 4,224 patients, 564 (13 %) were LEP. Of these LEP patients, 65.8 % never had a documented interpreter visit, 16.8 % utilized an interpreter with a non-MD, 12.6 % utilized an interpreter with a nonHospitalist MD and 4.8 % utilized an interpreter with a hospitalist present. In adjusted models, compared to English speakers, LEP patients with no interpreters had significantly shorter LOS. There were no differences in readmission rates and ED utilization between LEP and English-speaking patients. Compared to LEP patients with no interpreter use, those who had a physician use an interpreter had odds for a longer LOS, but there was no difference in odds of readmission or ED utilization. CONCLUSION: Academic hospital clinician use of interpreters remains highly variable and physicians may selectively be using interpreters for the sickest patients.KEY WORDS: limited English proficiency; interpreter use; length of stay; thirty-day readmissions.

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Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Use of Interpreters by Physicians for Hospitalized Limited English Proficient Patients and Its Impact on Patient Outcomes

et al. 2015

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“…3 Previous studies have demonstrated that patients with LEP experience health disparities including higher error and readmission rates in the hospital setting and less health education and healthcare utilization in the ambulatory setting. [4][5][6][7][8] Language barriers between the clinician and patient can disrupt effective communication and comprehension of healthcare information and place this growing population of vulnerable patients at heightened risk of inadequate informed consent. 7,9,10 Our prior systematic review found that professional interpreters improve patient-clinician communication for patients with LEP.…”

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confidence: 99%

Increased Access to Professional Interpreters in the Hospital Improves Informed Consent for Patients with Limited English Proficiency

et al. 2017

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BACKGROUND: Language barriers disrupt communication and impede informed consent for patients with limited English proficiency (LEP) undergoing healthcare procedures. Effective interventions for this disparity remain unclear. OBJECTIVE: Assess the impact of a bedside interpreter phone system intervention on informed consent for patients with LEP and compare outcomes to those of English speakers. DESIGN: Prospective, pre-post intervention implementation study using propensity analysis. SUBJECTS: Hospitalized patients undergoing invasive procedures on the cardiovascular, general surgery or orthopedic surgery floors. INTERVENTION: Installation of dual-handset interpreter phones at every bedside enabling 24-h immediate access to professional interpreters. MAIN MEASURES: Primary predictor: pre-vs. postimplementation group; secondary predictor: postimplementation patients with LEP vs. English speakers. Primary outcomes: three central informed consent elements, patient-reported understanding of the (1) reasons for and (2) risks of the procedure and (3) having had all questions answered. We considered consent adequately informed when all three elements were met. KEY RESULTS: We enrolled 152 Chinese-and Spanishspeaking patients with LEP (84 pre-and 68 postimplementation) and 86 English speakers. Postimplementation (vs. pre-implementation) patients with LEP were more likely to meet criteria for adequately informed consent (54% vs. 29%, p = 0.001) and, after propensity score adjustment, had significantly higher odds of adequately informed consent (AOR 2.56; 95% CI, 1.15-5.72) as well as of each consent element individually. However, compared to post-implementation English speakers, post-implementation patients with LEP had

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“…This language diversity can create barriers and add an additional burden for those with Limited English Proficiency (LEP) a population that already experiences a disparate risk of poor health outcomes (2). Language Services (LS) in hospitals facilitate quality access to care by increasing a patient's ability to comply with appointments and procedures resulting in reducing risk of adverse clinical outcomes, such as preventable readmissions, improving patient-provider communication, and increasing patient satisfaction (3)(4)(5)(6). In addition to being considered a critical component for the optimization of service quality in hospitals, empirical evidence suggests the absence or poor delivery of LS leads to disparities in health outcomes for LEP patients (7,8).…”

Section: Introductionmentioning

confidence: 99%

Predictors of language service availability in U.S. hospitals

Schiaffino

Al‐Amin

Schumacher

2014

Int J Health Policy Manag

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Background: Hispanics comprise 17% of the total U.S. population, surpassing African-Americans as the largest minority group. Linguistically, almost 60 million people speak a language other than English. This language diversity can create barriers and additional burden and risk when seeking health services. Patients with Limited English Proficiency (LEP) for example, have been shown to experience a disproportionate risk of poor health outcomes, making the provision of Language Services (LS) in healthcare facilities critical. Research on the determinants of LS adoption has focused more on overall cultural competence and internal managerial decision-making than on measuring LS adoption as a process outcome influenced by contextual or external factors. The current investigation examines the relationship between state policy, service area factors, and hospital characteristics on hospital LS adoption. Methods: We employ a cross-sectional analysis of survey data from a national sample of hospitals in the American Hospital Association (AHA) database for 2011 (N= 4876) to analyze hospital characteristics and outcomes, augmented with additional population data from the American Community Survey (ACS) to estimate language diversity in the hospital service area. Additional data from the National Health Law Program (NHeLP) facilitated the state level Medicaid reimbursement factor. Results: Only 64% of hospitals offered LS. Hospitals that adopted LS were more likely to be not-for-profit, in areas with higher than average language diversity, larger, and urban. Hospitals in above average language diverse counties had more than 2-fold greater odds of adopting LS than less language diverse areas [Adjusted Odds Ratio (AOR): 2.26, P< 0.01]. Further, hospitals with a strategic orientation toward diversity had nearly 2-fold greater odds of adopting LS (AOR: 1.90, P< 0.001). Conclusion: Our findings support the importance of structural and contextual factors as they relate to healthcare delivery. Healthcare organizations must address the needs of the population they serve and align their efforts internally. Current financial incentives do not appear to influence adoption of LS, nor do Medicaid reimbursement funds, thus suggesting that further alignment of incentives. Organizational and system level factors have a place in disparities research and warrant further analysis; additional spatial methods could enhance our understanding of population factors critical to system-level health services research.

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Professional Language Interpretation and Inpatient Length of Stay and Readmission Rates

Cited by 216 publications

References 12 publications

Use of Interpreters by Physicians for Hospitalized Limited English Proficient Patients and Its Impact on Patient Outcomes

Use of Interpreters by Physicians for Hospitalized Limited English Proficient Patients and Its Impact on Patient Outcomes

Increased Access to Professional Interpreters in the Hospital Improves Informed Consent for Patients with Limited English Proficiency

Predictors of language service availability in U.S. hospitals

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