Emergency department and inpatient health care utilization among patients who require interpreter services Utilization, expenditure, economics and financing systems

Jane W. Njeru, Jennifer St. Sauver, Debra J. Jacobson, Jon Owen Ebbert, Paul Y Takahashi, Chun Fan, Mark L. Wieland

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Limited English proficiency is associated with health disparities and suboptimal health outcomes. Although Limited English proficiency is a barrier to effective health care, its association with inpatient health care utilization is unclear. The aim of this study was to examine the association between patients with limited English proficiency, and emergency department visits and hospital admissions. Methods: We compared emergency department visits and hospitalizations in 2012 between patients requiring interpreter services and age-matched English-proficient patients (who did not require interpreters), in a retrospective cohort study of adult patients actively empanelled to a large primary health care network in a medium-sized United States city (n = 3,784). Results: Patients who required interpreter services had significantly more Emergency Department visits (841 vs 620; P.001) and hospitalizations (408 vs 343; P; .001) than patients who did not require interpreter services. On regression analysis the risk of a first Emergency Department visit was 60 % higher for patients requiring interpreter services than those who did not (unadjusted hazard ratio [HR], 1.6; 95 % confidence interval (CI), 1.4-1.9; P < .05), while that of a first hospitalization was 50 % higher (unadjusted HR, 1.5; 95 % CI, 1.2-1.8; P < .05). These findings remained significant after adjusting for age, sex, medical complexity, residency and outpatient health care utilization. Conclusions: Patients who required interpreter services had higher rates of inpatient health care utilization compared with patients who did not require an interpreter. Further research is required to understand factors associated with this utilization and to develop sociolinguistically tailored interventions to facilitate appropriate health care provision for this population.

Original languageEnglish (US)
Article number214
JournalBMC Health Services Research
Volume15
Issue number1
DOIs
StatePublished - May 29 2015

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Patient Acceptance of Health Care
Health Expenditures
Hospital Emergency Service
Inpatients
Economics
Hospitalization
Confidence Intervals
Delivery of Health Care
Health
Ambulatory Care
Internship and Residency
Primary Health Care
Cohort Studies
Retrospective Studies
Regression Analysis

Keywords

  • Health disparities
  • Health services research
  • Limited English proficiency

ASJC Scopus subject areas

  • Health Policy

Cite this

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title = "Emergency department and inpatient health care utilization among patients who require interpreter services Utilization, expenditure, economics and financing systems",
abstract = "Background: Limited English proficiency is associated with health disparities and suboptimal health outcomes. Although Limited English proficiency is a barrier to effective health care, its association with inpatient health care utilization is unclear. The aim of this study was to examine the association between patients with limited English proficiency, and emergency department visits and hospital admissions. Methods: We compared emergency department visits and hospitalizations in 2012 between patients requiring interpreter services and age-matched English-proficient patients (who did not require interpreters), in a retrospective cohort study of adult patients actively empanelled to a large primary health care network in a medium-sized United States city (n = 3,784). Results: Patients who required interpreter services had significantly more Emergency Department visits (841 vs 620; P.001) and hospitalizations (408 vs 343; P; .001) than patients who did not require interpreter services. On regression analysis the risk of a first Emergency Department visit was 60 {\%} higher for patients requiring interpreter services than those who did not (unadjusted hazard ratio [HR], 1.6; 95 {\%} confidence interval (CI), 1.4-1.9; P < .05), while that of a first hospitalization was 50 {\%} higher (unadjusted HR, 1.5; 95 {\%} CI, 1.2-1.8; P < .05). These findings remained significant after adjusting for age, sex, medical complexity, residency and outpatient health care utilization. Conclusions: Patients who required interpreter services had higher rates of inpatient health care utilization compared with patients who did not require an interpreter. Further research is required to understand factors associated with this utilization and to develop sociolinguistically tailored interventions to facilitate appropriate health care provision for this population.",
keywords = "Health disparities, Health services research, Limited English proficiency",
author = "Njeru, {Jane W.} and {St. Sauver}, Jennifer and Jacobson, {Debra J.} and Ebbert, {Jon Owen} and Takahashi, {Paul Y} and Chun Fan and Wieland, {Mark L.}",
year = "2015",
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T1 - Emergency department and inpatient health care utilization among patients who require interpreter services Utilization, expenditure, economics and financing systems

AU - Njeru, Jane W.

AU - St. Sauver, Jennifer

AU - Jacobson, Debra J.

AU - Ebbert, Jon Owen

AU - Takahashi, Paul Y

AU - Fan, Chun

AU - Wieland, Mark L.

PY - 2015/5/29

Y1 - 2015/5/29

N2 - Background: Limited English proficiency is associated with health disparities and suboptimal health outcomes. Although Limited English proficiency is a barrier to effective health care, its association with inpatient health care utilization is unclear. The aim of this study was to examine the association between patients with limited English proficiency, and emergency department visits and hospital admissions. Methods: We compared emergency department visits and hospitalizations in 2012 between patients requiring interpreter services and age-matched English-proficient patients (who did not require interpreters), in a retrospective cohort study of adult patients actively empanelled to a large primary health care network in a medium-sized United States city (n = 3,784). Results: Patients who required interpreter services had significantly more Emergency Department visits (841 vs 620; P.001) and hospitalizations (408 vs 343; P; .001) than patients who did not require interpreter services. On regression analysis the risk of a first Emergency Department visit was 60 % higher for patients requiring interpreter services than those who did not (unadjusted hazard ratio [HR], 1.6; 95 % confidence interval (CI), 1.4-1.9; P < .05), while that of a first hospitalization was 50 % higher (unadjusted HR, 1.5; 95 % CI, 1.2-1.8; P < .05). These findings remained significant after adjusting for age, sex, medical complexity, residency and outpatient health care utilization. Conclusions: Patients who required interpreter services had higher rates of inpatient health care utilization compared with patients who did not require an interpreter. Further research is required to understand factors associated with this utilization and to develop sociolinguistically tailored interventions to facilitate appropriate health care provision for this population.

AB - Background: Limited English proficiency is associated with health disparities and suboptimal health outcomes. Although Limited English proficiency is a barrier to effective health care, its association with inpatient health care utilization is unclear. The aim of this study was to examine the association between patients with limited English proficiency, and emergency department visits and hospital admissions. Methods: We compared emergency department visits and hospitalizations in 2012 between patients requiring interpreter services and age-matched English-proficient patients (who did not require interpreters), in a retrospective cohort study of adult patients actively empanelled to a large primary health care network in a medium-sized United States city (n = 3,784). Results: Patients who required interpreter services had significantly more Emergency Department visits (841 vs 620; P.001) and hospitalizations (408 vs 343; P; .001) than patients who did not require interpreter services. On regression analysis the risk of a first Emergency Department visit was 60 % higher for patients requiring interpreter services than those who did not (unadjusted hazard ratio [HR], 1.6; 95 % confidence interval (CI), 1.4-1.9; P < .05), while that of a first hospitalization was 50 % higher (unadjusted HR, 1.5; 95 % CI, 1.2-1.8; P < .05). These findings remained significant after adjusting for age, sex, medical complexity, residency and outpatient health care utilization. Conclusions: Patients who required interpreter services had higher rates of inpatient health care utilization compared with patients who did not require an interpreter. Further research is required to understand factors associated with this utilization and to develop sociolinguistically tailored interventions to facilitate appropriate health care provision for this population.

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