The Effect of Limited English Proficiency on Pediatric Hospital Readmissions

Hosp Pediatr. 2017 Jan;7(1):1-8. doi: 10.1542/hpeds.2016-0069. Epub 2016 Dec 6.

Abstract

Background: The relationship between limited English proficiency (LEP) and worse pediatric health outcomes is well documented.

Objectives: To determine the relationship between LEP status and pediatric hospital readmissions.

Methods: We performed a retrospective cohort analysis of children ≤ 18 years old admitted to a tertiary children's hospital from 2008 to 2014. The main exposure was LEP status. Independent variables included sex, age, race/ethnicity, insurance, median household income, surgical/medical status, severity of illness (SOI), the presence of a complex chronic condition, and length of stay. Primary outcome measures were 7- and 30-day readmission.

Results: From 67 473 encounters, 7- and 30-day readmission rates were 3.9% and 8.2%, respectively. LEP patients were more likely to be younger, poorer, and Hispanic; have lower SOI; and government-subsidized insurance. Adjusted odds for 7- or 30-day readmission for LEP versus English-proficient (EP) patients were 1.00 (P = .99) and 0.97 (P = .60), respectively. Hispanic ethnicity (adjusted odds ratio [aOR]: 1.26 [P = .002] and 1.14 [P = .02]), greater SOI (aOR: 1.04 [P < .001] and 1.05 [P < .001]), and the presence of a complex chronic condition (aOR: 2.31 [P < .001] and 3.03 [P < .001]) were associated with increased odds of 7- and 30-day readmission, respectively. White LEP patients had increased odds of 7- and 30-day readmission compared with white EP patients (aOR: 1.46 [P = .006] and 1.32 [P = .007]) and the poorest LEP patients had increased odds of 7- and 30-day readmission compared with the poorest EP patients (aOR: 1.77 [P = .04] and 2.00 [P < .001]).

Conclusions: This is the first large study evaluating the relationship between LEP and pediatric hospital readmission. There was no increased risk of readmission in LEP patients compared with EP patients.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Age Factors
  • Child
  • Child, Preschool
  • Cohort Studies
  • Communication Barriers*
  • Ethnicity
  • Female
  • Health Status Disparities
  • Healthcare Disparities / ethnology*
  • Hospitals, Pediatric / statistics & numerical data*
  • Humans
  • Male
  • Medical Overuse* / prevention & control
  • Medical Overuse* / statistics & numerical data
  • Patient Readmission / statistics & numerical data*
  • Retrospective Studies
  • Risk Factors
  • Socioeconomic Factors
  • Statistics as Topic
  • United States / epidemiology