Telephone triage utilization among patients with limited English proficiency

Jane W. Njeru, Swathi Damodaran, Frederick North, Debra J. Jacobson, Patrick M. Wilson, Jennifer St. Sauver, Carmen Radecki Breitkopf, Mark L. Wieland

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Communication between patients with limited English proficiency (LEP) and telephone triage services has not been previously explored. The purpose of this study was to determine the utilization characteristics of a primary care triage call center by patients with LEP. Methods: This was a retrospective cohort study of the utilization of a computer-aided, nurse-led telephone triage system by English proficiency status of patients empaneled to a large primary care practice network in the Midwest United States. Interpreter Services (IS) need was used as a proxy for LEP. Results: Call volumes between the 587 adult patients with LEP and an age-frequency matched cohort of English-Proficient (EP) patients were similar. Calls from patients with LEP were longer and more often made by a surrogate. Patients with LEP received recommendations for higher acuity care more frequently (49.4% versus 39.0%; P < 0.0004), and disagreed with recommendations more frequently (30.1% versus 20.9%; P = 0.0004). These associations remained after adjustment for comorbidities. Patients with LEP were also less likely to follow recommendations (60.9% versus 69.4%; P = 0.0029), even after adjusting for confounders (adjusted odds ratio [AOR] = 0.65; 95% confidence interval [CI], 0.49, 0.85; P < 0.001). Conclusion: Patients with LEP who utilized a computer-aided, nurse-led telephone triage system were more likely to receive recommendations for higher acuity care compared to EP patients. They were also less likely to agree with, or follow, recommendations given. Additional research is needed to better understand how telephone triage can better serve patients with LEP.

Original languageEnglish (US)
Article number706
JournalBMC Health Services Research
Volume17
Issue number1
DOIs
StatePublished - Nov 9 2017

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Triage
Telephone
Primary Health Care
Nurses
Proxy
Comorbidity
Cohort Studies
Retrospective Studies
Odds Ratio
Communication
Confidence Intervals

Keywords

  • Immigrants and refugees
  • Interpreter services
  • Limited English proficiency
  • Telephone triage

ASJC Scopus subject areas

  • Health Policy

Cite this

Telephone triage utilization among patients with limited English proficiency. / Njeru, Jane W.; Damodaran, Swathi; North, Frederick; Jacobson, Debra J.; Wilson, Patrick M.; St. Sauver, Jennifer; Radecki Breitkopf, Carmen; Wieland, Mark L.

In: BMC Health Services Research, Vol. 17, No. 1, 706, 09.11.2017.

Research output: Contribution to journalArticle

Njeru, Jane W. ; Damodaran, Swathi ; North, Frederick ; Jacobson, Debra J. ; Wilson, Patrick M. ; St. Sauver, Jennifer ; Radecki Breitkopf, Carmen ; Wieland, Mark L. / Telephone triage utilization among patients with limited English proficiency. In: BMC Health Services Research. 2017 ; Vol. 17, No. 1.
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abstract = "Background: Communication between patients with limited English proficiency (LEP) and telephone triage services has not been previously explored. The purpose of this study was to determine the utilization characteristics of a primary care triage call center by patients with LEP. Methods: This was a retrospective cohort study of the utilization of a computer-aided, nurse-led telephone triage system by English proficiency status of patients empaneled to a large primary care practice network in the Midwest United States. Interpreter Services (IS) need was used as a proxy for LEP. Results: Call volumes between the 587 adult patients with LEP and an age-frequency matched cohort of English-Proficient (EP) patients were similar. Calls from patients with LEP were longer and more often made by a surrogate. Patients with LEP received recommendations for higher acuity care more frequently (49.4{\%} versus 39.0{\%}; P < 0.0004), and disagreed with recommendations more frequently (30.1{\%} versus 20.9{\%}; P = 0.0004). These associations remained after adjustment for comorbidities. Patients with LEP were also less likely to follow recommendations (60.9{\%} versus 69.4{\%}; P = 0.0029), even after adjusting for confounders (adjusted odds ratio [AOR] = 0.65; 95{\%} confidence interval [CI], 0.49, 0.85; P < 0.001). Conclusion: Patients with LEP who utilized a computer-aided, nurse-led telephone triage system were more likely to receive recommendations for higher acuity care compared to EP patients. They were also less likely to agree with, or follow, recommendations given. Additional research is needed to better understand how telephone triage can better serve patients with LEP.",
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