Rory Meyers College of Nursing.
Stern School of Business.
Med Care. 2023 Sep 1;61(9):605-610. doi: 10.1097/MLR.0000000000001884. Epub 2023 Aug 10.
Language concordance between health care practitioners and patients have recently been shown to lower the risk of adverse health events. Continuity of care also been shown to have the same impact.
The purpose of this paper is to examine the relative effectiveness of both continuity of care and language concordance as alternative or complementary interventions to improve health outcomes of people with limited English proficiency.
A multivariable logistic regression model using rehospitalization as the dependent variable was built. The variable of interest was created to compare language concordance and continuity of care.
The final sample included 22,103 patients from the New York City area between 2010 and 2015 who were non-English-speaking and admitted to their home health site following hospital discharge.
The odds ratio (OR) average marginal effect (AME) of each included variable was calculated for model analysis.
When compared with low continuity of care and high language concordance, high continuity of care and high language concordance significantly decreased readmissions (OR=0.71, 95% CI: 0.62-0.80, P<0.001, AME=-4.95%), along with high continuity of care and low language concordance (OR=0.80, 95% CI: 0.74-0.86, P<0.001, AME=-3.26%). Low continuity of care and high language concordance did not significantly impact readmissions (OR=1.04, 95% CI: 0.86-1.26, P=0.672, AME=0.64%).
In the US home health system, enhancing continuity of care for those with language barriers may be helpful to address disparities and reduce hospital readmission rates.
最近的研究表明，医疗保健从业者与患者之间的语言一致性可以降低不良健康事件的风险。连续性护理也具有同样的影响。
本文旨在研究连续性护理和语言一致性作为改善语言能力有限的患者健康结果的替代或补充干预措施的相对有效性。
使用再入院作为因变量建立多变量逻辑回归模型。创建感兴趣的变量是为了比较语言一致性和连续性护理。
最终样本包括 2010 年至 2015 年期间来自纽约市地区的 22103 名非英语患者，他们在出院后被送往家庭健康站点。
计算每个纳入变量的比值比（OR）平均边际效应（AME）进行模型分析。
与低连续性护理和高语言一致性相比，高连续性护理和高语言一致性显著降低了再入院率（OR=0.71，95%CI：0.62-0.80，P<0.001，AME=-4.95%），以及高连续性护理和低语言一致性（OR=0.80，95%CI：0.74-0.86，P<0.001，AME=-3.26%）。低连续性护理和高语言一致性对再入院率没有显著影响（OR=1.04，95%CI：0.86-1.26，P=0.672，AME=0.64%）。
在美国家庭健康系统中，为有语言障碍的人增强连续性护理可能有助于解决差异问题并降低医院再入院率。
