Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.
Department of Biomedical Sciences, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
J Immigr Minor Health. 2024 Feb;26(1):3-14. doi: 10.1007/s10903-023-01561-7. Epub 2023 Oct 30.
Language barriers (LB) contribute to coronavirus disease 2019 (COVID-19) health inequities. People with LB were more likely to be SARS-CoV-2 positive despite lower testing and had higher rates of hospitalization. Data on hospital outcomes among immigrants with LB, however, are limited. We aimed to investigate the clinical outcomes of hospitalized COVID-19 cases by LB, immigration status, ethnicity, and access to COVID-19 health information and services prior to admission. Adults with laboratory-confirmed community-acquired COVID-19 hospitalized from March 1 to June 30, 2020, at four tertiary-care hospitals in Montréal, Quebec, Canada were included. Demographics, comorbidities, immigration status, country of birth, ethnicity, presence of LB, and hospital outcomes (ICU admission and death) were obtained through a chart review. Additional socio-economic and access to care questions were obtained through a phone survey. A Fine-Gray competing risk subdistribution hazards model was used to estimate the risk of ICU admission and in-hospital death by immigrant status, region of birth and LB Among 1093 patients, 622 (56.9%) were immigrants and 101 (16.2%) of them had a LB. One third (36%) of immigrants with LB did not have access to an interpreter during hospitalization. Admission to ICU and in-hospital mortality were not significantly different between groups. Prior to admission, one third (14/41) of immigrants with LB had difficulties accessing COVID-19 information in their mother tongue and one third (9/27) of non-white immigrants with a LB had difficulties accessing COVID-19 services. Immigrants with LB were inequitably affected by the first wave of the pandemic in Quebec, Canada. In our study, a large proportion had difficulties accessing information and services related to COVID-19 prior to admission, which may have increased SARS-CoV-2 exposure and hospitalizations. After hospitalization, a large proportion did not have access to interpreters. Providing medical information and care in the language of preference of increasing diverse populations in Canada is important for promoting health equity.
语言障碍（LB）导致了 2019 年冠状病毒病（COVID-19）的健康不平等。尽管检测率较低，但有 LB 的人更有可能检测出 SARS-CoV-2 呈阳性，并且住院率更高。然而，关于 LB 移民住院患者的医院结局的数据有限。我们旨在调查 LB、移民身份、族裔以及在入院前获取 COVID-19 健康信息和服务的情况对住院 COVID-19 病例的临床结局的影响。纳入 2020 年 3 月 1 日至 6 月 30 日在加拿大魁北克省蒙特利尔的四家三级护理医院住院的经实验室确诊的社区获得性 COVID-19 成年患者。通过病历回顾获得人口统计学、合并症、移民身份、出生国、族裔、LB 存在情况以及医院结局（入住 ICU 和死亡）。通过电话调查获得额外的社会经济和获得护理的问题。使用 Fine-Gray 竞争风险亚分布风险模型估计按移民身份、出生地区和 LB 分层的 ICU 入院和院内死亡风险。在 1093 名患者中，有 622 名（56.9%）是移民，其中 101 名（16.2%）有 LB。三分之一（36%）有 LB 的移民在住院期间无法获得口译员。入住 ICU 和院内死亡率在各组之间无显著差异。在入院前，三分之一（14/41）有 LB 的移民在母语获取 COVID-19 信息方面有困难，三分之一（9/27）有 LB 的非白人移民在获取 COVID-19 服务方面有困难。在加拿大魁北克省，LB 移民受到了大流行第一波的不平等影响。在我们的研究中，很大一部分人在入院前获取与 COVID-19 相关的信息和服务方面有困难，这可能增加了 SARS-CoV-2 的暴露和住院。住院后，很大一部分人无法获得口译员。为加拿大日益多样化的人群提供首选语言的医疗信息和护理对于促进健康公平至关重要。
