Factors affecting interpreter use in a pediatric emergency department
Hartford, Emily Altick
MetadataShow full item record
Approximately 9% of the US population has limited English proficiency (LEP) and this group experiences significant inequities in health care including access to care, diagnostic work ups, missed diagnoses, adverse events, difficulties with communication and education, and differential treatment of pain. Professional interpretation can improve these disparities, but its use varies in clinical settings. The objective of this study was to describe patterns of interpreter use in an academic pediatric emergency department and determine factors associated with use of an interpreter as well as differences in patient outcomes between LEP and English proficient (EP) populations. A retrospective cohort study was completed for over 51,000 ED encounters between October 2015 and December 2016. Overall interpreter use for families with LEP was 45.4%. Interpretation was less likely to be utilized during high volume times of the day (OR 0.85, 95% CI 0.78-0.93) and with lower acuity ESI (OR 0.66, 95% CI 0.62-0.70). The odds of receiving interpretation also decreased by 3% (OR 0.97, 95% CI 0.96-0.98) with each increasing year of patient age. In a comparison of LEP and EP patients, those with LEP were more likely to be assigned a lower acuity ESI level of 4 or 5 (p<0.001), less likely to be admitted than EP patients (OR 0.69, 0.62-0.78); those who did not receive interpretation were less likely to be admitted than those who did (OR 0.62, 0.53-0.71). However, LEP patients were more likely to be admitted to the ICU within 24 hours of admission (OR 1.43, 1.03-2). Professional interpretation is currently underutilized in this ED for patients with LEP. We identified important differences in patient outcomes between EP and LEP families and multiple factors where improvement efforts may be focused.
- Global health