Rosenthal J Walker, Bakillah Emna, Acker Rachael C, Sharpe James, Sharoky Catherine E, Kelz Rachel R
Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA; Center for Surgery and Health Economics, Department of Surgery, Philadelphia, PA, USA.
Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA; Center for Surgery and Health Economics, Department of Surgery, Philadelphia, PA, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
Am J Surg. 2025 Sep;247:116473. doi: 10.1016/j.amjsurg.2025.116473. Epub 2025 Jun 10.
Section 1557 of the Affordable Care Act mandates the use of professional medical language services for patients with limited English proficiency (LEP). Policy adherence rates and associated surgical outcomes are unknown.
A retrospective pilot study of 230 LEP patients ≥18 years undergoing cholecystectomy (January 2021-January 2024) was conducted at a single academic institution. The frequency of interpreter service use and language concordant documentation were abstracted from the electronic health record. Regression analysis was used to examine the association between section 1557 compliance and length of stay (LOS), emergency department (ED) re-visit, hospital readmission, and surgeon follow-up.
Interpreter use was documented for 62.2 % of patients and 30 % received language concordant documentation. Interpreter service utilization and language concordant documentation were not significantly associated with LOS, ED visits, hospital readmissions, or surgeon follow-up.
Language interpreter services are underutilized for LEP patients. These findings suggest the need for further investigation into the barriers to providing this service for patients during a time of critical decision-making.
《平价医疗法案》第1557条规定，必须为英语水平有限（LEP）的患者提供专业的医学语言服务。政策遵守率及相关手术结果尚不清楚。
在一家学术机构对230名年龄≥18岁、接受胆囊切除术的LEP患者（2021年1月至2024年1月）进行了一项回顾性试点研究。从电子健康记录中提取口译服务使用频率和语言匹配文档。采用回归分析来检验第1557条合规情况与住院时间（LOS）、急诊科（ED）复诊、医院再入院和外科医生随访之间的关联。
62.2%的患者有口译服务记录，30%的患者有语言匹配文档。口译服务利用情况和语言匹配文档与LOS、ED就诊、医院再入院或外科医生随访均无显著关联。
LEP患者对口译服务的利用率较低。这些发现表明，需要进一步调查在关键决策时期为患者提供这项服务的障碍。
