Emergency providers delay the initiation of care for patients with Limited English Proficiency

Patients with Limited English Proficiency (LEP) experience delays in the initiation of their emergency department (ED) care due to barriers in obtaining a medical interpreter. This delay may negatively affect their experience and lead to downstream health inequities. This study aimed to analyze whether LEP patients wait longer to be seen once they are moved into an ED room.

This is a retrospective analysis of data from two affiliated EDs with similar ED triage processes. The primary aim was defined as the time to physician self-assignment (TTPS). The TTPS was compared between those who required an interpreter and those who did not. These differences were analyzed using appropriate descriptive and inferential statistical methods.

47,038 encounters were included for analysis, with 3259 (6.9%) of these for patients who had a documented need for an interpreter. Weighted median TTPS for patients who required an interpreter was 7.4 [6.7, 8.2] minutes while those who did not require an interpreter was 5.8 [5.7, 5.9] minutes. This difference represented a 27% increase in TTPS relative to patients without interpreter need. When TTPS was stratified by race, this remained statistically significant for White (4.5 min) and Black patients (2.1 min).

In this patient population, patients who required an interpreter waited longer to be evaluated by an emergency provider. The reasons for this difference and the downstream implications of this result remain unclear.