A Discrete Choice Experiment to Understand Hospital Discharge Preferences of Populations with Non-English Language...

Effective hospital discharge communication is crucial to reducing adverse outcomes and readmissions particularly for patients with non-English language preference (NELP). However, little evidence exists on which specific discharge elements are most valued by this population.

To quantify preferences for aspects of hospital discharge among hospitalized patients with NELP and examine how demographic and language-related factors are associated with these preferences.

A discrete choice experiment (DCE) was conducted in which participants were presented with pairs of hypothetical discharge scenarios. Each scenario was defined by one level per attribute across four discharge communication attributes: family involvement during teaching (none, by phone, or in person), mode of verbal communication (language-concordant clinician, in-person interpreter, phone interpreter, or video interpreter), record of discharge instructions (written in English, written in preferred language, or audio-recorded in preferred language), and type of post-discharge phone contact (call from primary care nurse, call from hospital nurse, or a number for patients to call). Participants selected their preferred scenario across 20 choice sets.

Hospitalized Spanish- and Haitian Creole-speaking adults at a single urban safety-net hospital (n = 89).

Relative attribute importance and level preferences. Mixed logit models estimated overall and subgroup preferences by language and acculturation measures, with choice simulations generating predicted selection probabilities.

Record of discharge instructions held the greatest relative importance (39.9% decision weight; 95% CI 34.0%-44.5%), followed by mode of verbal communication (34.7%; 95% CI 29.0%-39.1%). Overall participants preferred language-concordant providers, audio-recorded and written instructions in their preferred language, and family involvement. Preferences varied within and between demographic and language-related groups.

Hospitalized patients with NELP prioritize language-concordant, multimodal discharge communication, particularly written instructions in their preferred language and discharge teaching from language-concordant staff. Health systems should prioritize implementing these strategies to improve the patient-centeredness of transitional care programs.