Samuels-Kalow Margaret E, Stack Anne M, Amico Kendra, Porter Stephen C
From the *Children's Hospital of Philadelphia, Philadelphia, PA; †Children's Hospital Boston; and ‡Harvard Affiliated Emergency Medicine Residency (BWH/MGH), Boston, MA; and §The Hospital for Sick Children; and ∥Department of Pediatrics, University of Toronto, Toronto, Canada.
Pediatr Emerg Care. 2017 Jun;33(6):402-404. doi: 10.1097/PEC.0000000000000592.
Return visits to the emergency department (ED) are used as a marker of quality of care. Limited English proficiency, along with other demographic and disease-specific factors, has been associated with increased risk of return visit, but the relationship between language, short-term return visits, and overall ED use has not been well characterized.
This is a planned secondary analysis of a prospective cohort examining the ED discharge process for English- or Spanish-speaking parents of children aged 2 months to 2 years with fever and/or respiratory illness. At 1 year after the index visit, a standardized chart review was performed. The primary outcome was the number of ED visits within 72 hours of the index visit. Multivariable logistic regression was used to examine the relative importance of predictor variables and adjust for confounders.
There were 202 parents eligible for inclusion, of whom 23% were Spanish speaking. In addition, 6.9% of the sample had a return visit within 72 hours. After adjustment for confounders, Spanish language was associated with return visit within 72 hours (odds ratio, 3.49; 95% confidence interval, 1.02-11.90) but decreased risk of a second visit within the year (odds ratio, 0.28; 95% confidence interval, 0.12-0.66).
Spanish-speaking parents are at an increased risk of 72-hour return ED visit but do not seem to be at increased risk of ED use during the year after their ED visit.
急诊复诊被用作医疗质量的一项指标。英语水平有限，连同其他人口统计学及疾病特异性因素，都与复诊风险增加有关，但语言、短期复诊及急诊总体利用之间的关系尚未得到充分描述。
这是一项对前瞻性队列进行的计划二次分析，该队列研究了2个月至2岁发热和/或呼吸道疾病患儿的讲英语或西班牙语的家长的急诊出院过程。在首次就诊后1年，进行了标准化的病历审查。主要结局是首次就诊后72小时内的急诊就诊次数。采用多变量逻辑回归分析来检验预测变量的相对重要性并对混杂因素进行校正。
有202名家长符合纳入条件，其中23%讲西班牙语。此外，6.9%的样本在72小时内进行了复诊。在对混杂因素进行校正后，西班牙语与72小时内的复诊有关（比值比，3.49；95%置信区间，1.02 - 11.90），但在年内第二次就诊的风险降低（比值比，0.28；95%置信区间，0.12 - 0.66）。
讲西班牙语的家长在72小时内急诊复诊的风险增加，但在其急诊就诊后的一年内急诊利用风险似乎并未增加。
