Greenky David, Levine Alyssa, Gillespie Scott E, Murray Brittany
Department of Pediatrics, Emory University School of Medicine, USA.
Emory University School of Medicine, Atlanta, GA, USA.
Emerg Med Int. 2019 Mar 11;2019:4832045. doi: 10.1155/2019/4832045. eCollection 2019.
Previous studies in pediatric emergency departments (EDs) showed patients with limited English proficiency (LEP) had gaps in care compared with English-speaking patients. In 2010, the Joint Commission released patient-centered communication standards addressing these gaps. We evaluate the current care of LEP patients in the Children's Healthcare of Atlanta (CHOA) EDs.
This was a retrospective cohort study of patients <18 years that presented to our EDs in 2016. Length of stay (LOS), change in triage status, return-visit rates, and hospital disposition were compared between patients who requested an interpreter and those who did not.
The population included 152,945 patients from 232,787 ED encounters in 2016. Interpreters were requested for 12.1% of encounters. For ED LOS, a model-adjusted difference of 0.77% was found between interpreter groups. For change in triage status, adjusted odds were 7% higher in the interpreter requested cohort. For ED readmission within 7 days, adjusted odds were 3% higher in the interpreter requested cohort. These effect sizes are small (ES < 0.2).
Our study showed low ES of the differences in ED metrics between LEP and English-speaking patients, suggesting little clinical difference between the two groups. The impact of this improvement should be further studied.
先前在儿科急诊科进行的研究表明，与英语流利的患者相比，英语水平有限（LEP）的患者在医疗护理方面存在差距。2010年，联合委员会发布了以患者为中心的沟通标准，以解决这些差距。我们评估了亚特兰大儿童医疗保健中心（CHOA）急诊科目前对LEP患者的护理情况。
这是一项对2016年到我们急诊科就诊的18岁以下患者的回顾性队列研究。比较了请求口译服务的患者和未请求口译服务的患者之间的住院时间（LOS）、分诊状态变化、复诊率和出院去向。
该人群包括2016年来自232,787次急诊科就诊的152,945名患者。12.1%的就诊请求了口译服务。对于急诊科住院时间，口译服务组之间的模型调整差异为0.77%。对于分诊状态变化，请求口译服务的队列中调整后的几率高7%。对于7天内的急诊科再入院，请求口译服务的队列中调整后的几率高3%。这些效应量较小（ES<0.2）。
我们的研究表明，LEP患者和英语流利患者在急诊科指标上的差异效应量较低，表明两组之间临床差异不大。这种改善的影响应进一步研究。
