Thiessen Molly, Hopkins Emily, Whitfield Jennifer, Rodrigues Kristine, Richards David, Warner Leah, Haukoos Jason
Denver Health Medical Center, Department of Emergency Medicine, Denver, Colorado.
University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado.
West J Emerg Med. 2025 Jul 9;26(4):960-969. doi: 10.5811/westjem.18610.
The COVID-19 pandemic had a disproportionate impact on minority communities, including patients who identify as having a preferred language other than English (PLOE). Our primary goal in this study was to evaluate the effect of the COVID-19 pandemic on patients with a PLOE in the emergency department (ED), and the use of interpreter services. Secondary outcomes evaluated were measures of patient care, including length of stay, number of studies performed, and unplanned return visits to the ED.
We performed an interrupted time series study of prospectively collected electronic health record (EHR) adult ED and language services data from an urban, safety-net hospital.
The total number of patients presenting to the ED went down in the early peak of the pandemic; however, the percentage of patients with a PLOE went up compared with previous years (19% vs 16%) and, despite making up only 19% of total patients, comprised 44% of total COVID-19 positive patients. In-person interpreter use decreased (prevalence ratio 0.49, 95% confidence Interval [CI] 0.43-0.56) while telephonic and video interpretation increased (prevalence ratio 3.97, 95% CI 3.56-4.43). Baseline testing was unchanged. All groups experienced a decrease in median LOS in 2020, but this was only found to be significant for patients who speak a language other than English or Spanish (P<0.001). None of the patient groups experienced a significant increase in unscheduled returns in 2020.
Our data confirms that COVID-19 disproportionately affected patients with a PLOE, with patients with a PLOE 2.9 times more likely to test positive for COVID-19 than their English-speaking counterparts. Efforts should be made to mitigate this effect via language-concordant care, professional interpreters, and culturally appropriate interaction and information dissemination, not only as it relates to planning for public health crises, but in the day-to-day function of the healthcare system at large. Continued research into the factors driving these inequities and ways to mitigate them is warranted.
2019年冠状病毒病（COVID-19）大流行对少数族裔社区产生了不成比例的影响，包括那些表明自己的首选语言不是英语（PLOE）的患者。本研究的主要目标是评估COVID-19大流行对急诊科（ED）中PLOE患者的影响以及口译服务的使用情况。评估的次要结果是患者护理指标，包括住院时间、进行的检查数量以及非计划返回急诊科的次数。
我们对一家城市安全网医院前瞻性收集的成人急诊科电子健康记录（EHR）和语言服务数据进行了中断时间序列研究。
在大流行的早期高峰阶段，到急诊科就诊的患者总数下降；然而，与前几年相比，PLOE患者的比例有所上升（19%对16%），并且尽管仅占总患者的19%，但却占COVID-19阳性患者总数的44%。面对面口译的使用减少（患病率比0.49，95%置信区间[CI]0.43 - 0.56），而电话和视频口译增加（患病率比3.97，95%CI 3.56 - 4.43）。基线检测没有变化。所有组在2020年的住院时间中位数均有所下降，但仅发现对于说英语或西班牙语以外语言的患者这一下降具有统计学意义（P<0.001）。2020年没有患者组的非计划返回次数出现显著增加。
我们的数据证实，COVID-19对PLOE患者产生了不成比例的影响，PLOE患者COVID-19检测呈阳性的可能性是说英语患者的2.9倍。应努力通过语言匹配的护理、专业口译以及文化上适当的互动和信息传播来减轻这种影响，这不仅涉及公共卫生危机的规划，也涉及整个医疗系统的日常运作。有必要继续研究导致这些不平等现象的因素以及减轻这些因素的方法。
