Increased Time to Provider for Patients With a Non-English Language Preference: A Retrospective Cohort Study

We assessed time to provider (TTP) for patients with a non-English language preference (NELP) compared to patients with an English language preference (ELP) in the emergency department (ED).

We conducted a retrospective cohort study of adults presenting between 2019 and 2023 to a large urban ED. We used a 2-step classification that first identified NELP from patients' reported language at registration, followed by identification in the narrative text of the triage note. We compared TTP among patients with a triage note-identified NELP, triage note-unidentified NELP, and ELP, including at night and during times of ED crowding.

Among 262,203 visits, 8227 were patients with a NELP, of which 3375 were triage note-identified NELP. The median TTP was 11 minutes for patients with an ELP (95% CI, 11-11), 15 minutes for triage note-identified NELP (14-16), and 13 minutes for triage note-unidentified NELP (12-14). During times of ED crowding, patients with an ELP had a median TTP of 12 minutes (95% CI, 12-12) compared with 21 minutes for patients with a triage note-identified NELP (17-27) and 17 minutes for those with a triage note-unidentified NELP (14-20). At nighttime, the median TTP was 19 minutes for patients with an ELP (95% CI, 19-19) compared with 28 minutes for triage note-identified NELP (25-32) and 25 minutes for triage note-unidentified NELP (22-28).

Patients with a NELP experience longer TTP, especially those whose triage note identifies their language status. ED crowding and nighttime are associated with further increases in TTP among patients with a NELP.