Influence of language barriers on outcomes of hospital care for general medicine inpatients.

BACKGROUND

Few studies have examined whether patients with language barriers receive worse hospital care in terms of quality or efficiency.

OBJECTIVE

: To examine whether patients' primary language influences hospital outcomes.

DESIGN AND SETTING

Observational cohort of urban university hospital general medical admissions between July 1, 2001 to June 30, 2003.

PATIENTS

Eighteen years old or older whose hospital data included information on their primary language, specifically English, Russian, Spanish or Chinese.

MEASUREMENTS

Hospital costs, length of stay (LOS), and odds for 30-day readmission or 30-day mortality.

RESULTS

Of 7023 admitted patients, 84% spoke English, 8% spoke Chinese, 4% Russian and 4% Spanish. In multivariable models, non-English and English speakers had statistically similar total cost, LOS, and odds for mortality. However, non-English speakers had higher adjusted odds of readmission (odds ratio [OR], 1.3; 95% confidence interval [CI], 1.0-1.7). Higher odds for readmission persisted for Chinese and Spanish speakers when compared to all English speakers (OR, 1.7; 95% CI, 1.2-2.3 and OR, 1.5; 95% CI, 1.0-2.3 respectively).

CONCLUSIONS

After accounting for socioeconomic variables and comorbidities, non-English speaking Latino and Chinese patients have higher risk for readmission. Whether language barriers produce differences in readmission or are a marker for less access to post-hospital care remains unclear. Journal of Hospital Medicine 2010;5:276-282. (c) 2010 Society of Hospital Medicine.