Lucy Schulson1,2, Meng-Yun Lin3, Michael K Paasche-Orlow4, Amresh D Hanchate3. 1. Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA. schulson@rand.org. 2. RAND Corporation, 20 Park Plaza #920, Boston, MA, 02116, USA. schulson@rand.org. 3. Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA. 4. Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
Abstract
BACKGROUND: Little is known about the risk of admission for emergency department (ED) visits for ambulatory care sensitive conditions (ACSCs) by limited English proficient (LEP) patients. OBJECTIVE: Estimate admission rates from ED for ACSCs comparing LEP and English proficient (EP) patients and examine how these rates vary at hospitals with a high versus low proportion of LEP patients. DESIGN: Retrospective cohort study of California's 2017 inpatient and ED administrative data PARTICIPANTS: Community-dwelling individuals ≥ 18 years without a primary diagnosis of pregnancy or childbirth. LEP patients had a principal language other than English. MAIN MEASURES: We used a series of linear probability models with incremental sets of covariates, including patient demographics, primary diagnosis, and Elixhauser comorbidities, to examine admission rate for visits of LEP versus EP patients. We then added an interaction covariate for high versus low LEP-serving hospital. We estimated models with and without hospital-level random effects. KEY RESULTS: These analyses included 9,641,689 ED visits; 14.7% were for LEP patients. . Observed rate of admission for all ACSC ED visits was higher for LEP than for EP patients (26.2% vs. 25.2; p value < .001). Adjusted rate of admission was not statistically significant (27.3% [95% CI 25.4-29.3%] vs. 26.2% [95% CI 24.3-28.1%]). For COPD, the difference was significant (36.8% [95% CI 35.0-38.6%] vs. 33.3% [95% CI 31.7-34.9%]). Difference in adjusted admission rate for LEP versus EP visits did not differ in high versus low LEP-serving hospitals. CONCLUSIONS: In adjusted analyses, LEP was not a risk factor for admission for most ACSCs. This finding was observed in both high and low LEP-serving hospitals.
BACKGROUND: Little is known about the risk of admission for emergency department (ED) visits for ambulatory care sensitive conditions (ACSCs) by limited English proficient (LEP) patients. OBJECTIVE: Estimate admission rates from ED for ACSCs comparing LEP and English proficient (EP) patients and examine how these rates vary at hospitals with a high versus low proportion of LEP patients. DESIGN: Retrospective cohort study of California's 2017 inpatient and ED administrative data PARTICIPANTS: Community-dwelling individuals ≥ 18 years without a primary diagnosis of pregnancy or childbirth. LEP patients had a principal language other than English. MAIN MEASURES: We used a series of linear probability models with incremental sets of covariates, including patient demographics, primary diagnosis, and Elixhauser comorbidities, to examine admission rate for visits of LEP versus EP patients. We then added an interaction covariate for high versus low LEP-serving hospital. We estimated models with and without hospital-level random effects. KEY RESULTS: These analyses included 9,641,689 ED visits; 14.7% were for LEP patients. . Observed rate of admission for all ACSC ED visits was higher for LEP than for EP patients (26.2% vs. 25.2; p value < .001). Adjusted rate of admission was not statistically significant (27.3% [95% CI 25.4-29.3%] vs. 26.2% [95% CI 24.3-28.1%]). For COPD, the difference was significant (36.8% [95% CI 35.0-38.6%] vs. 33.3% [95% CI 31.7-34.9%]). Difference in adjusted admission rate for LEP versus EP visits did not differ in high versus low LEP-serving hospitals. CONCLUSIONS: In adjusted analyses, LEP was not a risk factor for admission for most ACSCs. This finding was observed in both high and low LEP-serving hospitals.
Authors: Rachel Mayo; Veronica G Parker; Windsor W Sherrill; Kinneil Coltman; Matthew F Hudson; Christina M Nichols; Adam M Yates; Anne Paige Pribonic Journal: Hisp Health Care Int Date: 2016-04-29
Authors: Bianca T Villalobos; Ana J Bridges; Elizabeth A Anastasia; Carlos A Ojeda; Juventino Hernandez Rodriguez; Debbie Gomez Journal: Psychol Serv Date: 2015-09-07
Authors: Lucy Schulson; Victor Novack; Peter B Smulowitz; Tenzin Dechen; Bruce E Landon Journal: J Gen Intern Med Date: 2018-09-05 Impact factor: 6.473
Authors: Quyen Ngo-Metzger; Dara H Sorkin; Russell S Phillips; Sheldon Greenfield; Michael P Massagli; Brian Clarridge; Sherrie H Kaplan Journal: J Gen Intern Med Date: 2007-11 Impact factor: 5.128
Authors: William A Calo; Laura Cubillos; James Breen; Megan Hall; Krycya Flores Rojas; Rachel Mooneyham; Jennifer Schaal; Christina Yongue Hardy; Gaurav Dave; Mónica Pérez Jolles; Nacire Garcia; Daniel S Reuland Journal: BMC Health Serv Res Date: 2015-12-23 Impact factor: 2.655