Language of Caregiver and Pediatric Day-of-Surgery Cancellations

To examine the relationship between language used by a caregiver and day-of-surgery cancellations, and to distinguish whether neighborhood opportunity influences this relationship.

We performed a retrospective study of 173 533 children <18 years of age at a single institution who were scheduled for ambulatory surgery from 2017 through 2022. We estimated the odds of day-of-surgery cancellation by caregiver language, stratifying by neighborhood opportunity. We then determined the relative excess risk due to interaction of language other than English (LOE) with neighborhood opportunity.

Day-of-surgery cancellation occurred in 3.7% and 5.2% of children with caregivers using English and LOE, respectively (P < .001). Children from disadvantaged neighborhoods with caregivers using English had 23% lower odds of cancellation than those using LOE for care (OR 0.77, 95%CI 0.71-0.85; P < .001). Children from advantaged neighborhoods with caregivers using English had 38% lower odds of cancellation than those using LOE for care (OR 0.62, 95%CI 0.52-0.72; P < .001). The interaction between language and neighborhood advantage was not significant, indicating that neighborhood advantage does not appear to buffer those using LOE from cancellations (relative excess risk due to interaction: -0.06, 95%CI -0.21 to 0.08; P = .40).

Children with caregivers using LOE for care experience higher odds of day-of-surgery cancellation than children with caregivers using English, regardless of neighborhood opportunity. Decreasing language barriers is key to equitable surgery access.