Interpreter Modalities and Unplanned Emergency Department Revisits in Limited English Proficiency Patients.

INTRODUCTION

Emergency department encounters include an increasing number of patients with limited English proficiency, yet little is known about the impact of interpreter services on unplanned revisits to the emergency department. This study aims to assess interpreters' utilization and unplanned ED revisits, serving as an indicator of care quality.

METHODS

This was a single-center, retrospective chart review of ED visits at an urban academic center between January and April 2019. Inclusion criteria involved patients aged >18, discharged after evaluation, and with at least 1 ED revisit in the study period. Demographic data, interpreter modality, and revisit incidences within 72 hours and 30 days were analyzed using Chi-squared and Wilcoxon rank-sum tests.

RESULTS

Of 786 reviewed charts, 401 limited English proficiency patients and 294 controls matched by gender, race, and ethnicity were included. Among limited English proficiency patients, the majority identified as Hispanic (84.8% vs 36%, P<.01) and showed higher 72-hour unplanned revisit rates (2.8% vs 0.7%, P = .05). Interpreter documentation for limited English proficiency patients was only 49.6%, with in-person modality prevailing (45.8%). Trained interpreters were underutilized (13% in-person vs 7.7% video, P<.0001). Only 78% (P<.01) of patients with limited English proficiency received discharge instructions in their preferred language.

DISCUSSION

This study reveals a higher unplanned ED revisit rate among limited English proficiency patients, potentially linked to varying interpreter modality effectiveness and underutilization of trained interpreters. Emphasizing the critical role of trained interpreters, these findings offer an opportunity to enhance care quality for limited English proficiency patients in the emergency department.