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Published on: November 9, 2016
Language barriers and resource utilization in a pediatric emergency department
L C Hampers1, S Cha, D J Gutglass
1Department of Pediatrics, Northwestern University Medical School, Children's Memorial Hospital, Chicago, Illinois, USA. l-hampers@nwu.edu
A language barrier between physicians and families in the emergency department (ED) led to increased diagnostic testing costs and longer patient stays. This highlights a need for more efficient care for non-English-speaking patients.
Area of Science:
- Health Services Research
- Medical Informatics
- Clinical Practice
Background:
- Language barriers (LB) are known obstacles in US healthcare.
- Clinician diagnostic approaches during LBs are not well understood.
Purpose of the Study:
- To determine if a LB between families and emergency department (ED) physicians impacts diagnostic testing and ED length of stay.
Main Methods:
- Prospective cohort study of 2467 pediatric patients (2 months to 10 years) in an ED.
- Physicians recorded clinical status, LB presence, and Yale Observation Score.
- Diagnostic test charges and ED length of stay were compared between groups.
Main Results:
- 8.5% of cases involved a physician-family LB.
- LB patients were more likely to be Hispanic and less likely to be insured.
- LB cases had significantly higher mean test charges ($145 vs $104) and longer ED stays (165 vs 137 minutes).
- Controlling for other factors, LB was associated with $38 higher testing charges and 20 minutes longer ED stay.
Conclusions:
- Physician-family LBs are associated with increased resource utilization and ED visit times.
- Further research is needed to understand these differences and improve care efficiency for non-English-speaking patients.
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