School of Public Health, Queensland University of Technology, Brisbane, Queensland, Australia.
Emerg Med Australas. 2013 Feb;25(1):40-5. doi: 10.1111/1742-6723.12017. Epub 2012 Nov 29.
To compare access and utilisation of EDs in Queensland public hospitals between people who speak only English at home and those who speak another language at home.
A retrospective analysis of a Queensland statewide hospital ED dataset (ED Information System) from 1 January 2008 to 31 December 2010 was conducted. Access to ED care was measured by the proportion of the state's population attending EDs. Logistic regression analyses were performed to determine the relationships between ambulance use and language, and between hospital admission and language, both after adjusting for age, sex and triage category.
The ED utilisation rate was highest in English only speakers (290 per 1000 population), followed by Arabic speakers (105), and lowest among German speakers (30). Compared with English speakers, there were lower rates of ambulance use in Chinese (odds ratio 0.50, 95% confidence interval, 0.47-0.54), Vietnamese (0.87, 0.79-0.95), Arabic (0.87, 0.78-0.97), Spanish (0.56, 0.50-0.62), Italian (0.88, 0.80-0.96), Hindi (0.61, 0.53-0.70) and German (0.87, 0.79-0.90) speakers. Compared with English speakers, German speakers had higher admission rates (odds ratio 1.17, 95% confidence interval, 1.02-1.34), whereas there were lower admission rates in Chinese (0.90, 0.86-0.99), Arabic (0.76, 0.67-0.85) and Spanish (0.83, 0.75-0.93) speakers.
This study showed that there was a significant association between lower utilisation of emergency care and speaking languages other than English at home. Further researches are needed using in-depth methodology to investigate if there are language barriers in accessing emergency care in Queensland.
比较在昆士兰州公立医院急诊部(ED)就诊的仅讲英语者和在家讲其他语言者的就诊和利用情况。
对 2008 年 1 月 1 日至 2010 年 12 月 31 日昆士兰州全州医院急诊部(ED 信息系统)的医院 ED 数据集进行回顾性分析。利用该州人口中到 ED 就诊的比例来衡量 ED 医疗服务的可及性。在调整年龄、性别和分诊类别后,使用逻辑回归分析来确定语言与使用救护车以及语言与住院治疗之间的关系。
仅讲英语者的 ED 利用率最高(每 1000 人中有 290 人),其次是讲阿拉伯语者(105 人),讲德语者最低(30 人)。与讲英语者相比,讲中文者使用救护车的比率较低(比值比 0.50,95%置信区间 0.47-0.54),讲越南语者(0.87,0.79-0.95)、阿拉伯语者(0.87,0.78-0.97)、西班牙语者(0.56,0.50-0.62)、意大利语者(0.88,0.80-0.96)、印地语者(0.61,0.53-0.70)和德语者(0.87,0.79-0.90)较低。与讲英语者相比,讲德语者的住院率较高(比值比 1.17,95%置信区间 1.02-1.34),而讲中文者(0.90,0.86-0.99)、阿拉伯语者(0.76,0.67-0.85)和西班牙语者(0.83,0.75-0.93)的住院率较低。
本研究表明,在急诊部就诊率较低和在家讲英语以外的其他语言之间存在显著关联。需要进一步采用深入的方法研究在昆士兰州是否存在获取急诊服务的语言障碍。