Lost in Translation? Impact of Patient Language on Wait Times in a Pediatric Emergency Department

To examine the association between patients' preferred language and wait times in the pediatric emergency department (PED), hypothesizing that patients preferring languages other than English (LOE) wait longer to see a provider.

We conducted a retrospective analysis of patients arriving at a PED between January 2022 and December 2023. Patient demographic and wait time data were obtained from the electronic health record. Bivariate and multivariable regression analyses examined the relationship between wait times and covariates, including preferred language, race and ethnicity, primary insurance, and illness acuity.

A total of 96 273 patients and 90 544 patients were included in bivariate and multivariable analyses, respectively. Bivariate analyses showed wait time differences from rooming to provider evaluation for language and race and ethnicity (P < .05). Multivariable linear regression analyses showed patients preferring LOE waited an adjusted 1.1 minutes longer for triage (95% CI, 0.7-1.4), 5.5 minutes longer for rooming (95% CI, 4.4-6.6), and 3.8 minutes longer for provider evaluation after rooming (95% CI, 3.4-4.2) compared with patients preferring English. Non-white patients and patients preferring LOE had shorter times to disposition, 4.1 minutes (95% CI, 1.5-6.8) and 7.2 minutes (95% CI 5.1-9.2) faster, and lower odds of hospital admission, adjusted odds ratios of 0.71 (95% CI, 0.69-0.74) and 0.74 (95% CI, 0.7-0.78), respectively.

Patients preferring LOE experienced longer wait times for provider evaluation but shorter times to disposition after initial assessment and lower adjusted odds of hospital admission. Non-white patients experienced lower adjusted hospital admission odds, raising concerns about differences in clinical decision-making based on demographic characteristics.