Language matters: Variation in surgical readmissions across non-English language subgroups and hospitals

Area of Science:

• Health Services Research
• Health Disparities
• Surgical Outcomes

Background:

• Patients with Limited English Proficiency (LEP) experience worse surgical outcomes.
• Hospitals vary significantly in their capacity to provide language access services.
• Effective language services are crucial for equitable healthcare delivery.

Purpose of the Study:

• To compare 7-day readmission rates for adult surgical patients with LEP.
• The study stratified outcomes by hospital language-serving status (LSH vs. non-LSH).
• Analysis included stratification by language groups: Spanish, Common Non-English Non-Spanish (NENS), and Rare NENS languages.

Main Methods:

• Utilized the New Jersey State Inpatient Database for analysis.
• Included 34,342 adult surgical patients discharged from hospitals.
• Compared readmission rates between Language Serving Hospitals (LSH) and non-LSH.

Main Results:

• Patients discharged from LSH had a 2.5% readmission rate versus 5.0% from non-LSH.
• LEP patients from LSH showed reduced odds of readmission across Spanish (aOR 0.46), Common NENS (aOR 0.49), and Rare NENS (aOR 0.50) language groups.
• These findings indicate a significant benefit of LSH for diverse LEP populations.

Conclusions:

• Discharge from Language Serving Hospitals (LSH) is associated with lower readmission odds for surgical patients with LEP.
• LSH appear better equipped to manage care for LEP patients, potentially reducing readmissions.
• Disparities persist for Common and Rare NENS languages, underscoring the need for expanded language resources beyond Spanish.