Language Serving Hospitals and their Impact on Readmission for Surgical Patients with a Non-English Primary Language: A Retrospective Cohort Study.

Abstract

Objective: To assess postoperative readmission for patients with non-English primary language (NEPL) at Language Serving Hospitals (LSH) versus non-LSH.

Summary background data: Patients with NEPL have worse surgical outcomes compared to patients with an English primary language. Hospital-level language access resources vary, potentially leading to disparate health outcomes.

Methods: We performed a retrospective cohort study from 2010-2022 using the New Jersey AHRQ-HCUP State Inpatient Database. Patients with a primary language variable seen at a hospital that met LSH or non-LSH criteria were identified. Patients with NEPL and who underwent appendectomy, breast surgery, cholecystectomy, colectomy, or lower extremity arterial revascularization and were discharged to home were included. LSH are hospitals where the proportion of patients with NEPL served meets or exceeds the proportion of NJ's population with LEP (12.3%). The primary outcome was 7-day readmission. Multivariable logistic regression was performed, adjusting for patient-level confounders.

Results: We included 28,157 patients with NEPL and identified 17 LSH and 43 non-LSH. The proportion of patients readmitted (2.6% vs. 5.7%, P<0.001) was lower at LSH compared to non-LSH. Patients discharged from LSH had a 56% lower likelihood of readmission compared to those at non-LSH (aOR 0.44, 95% CI 0.39-0.50).

Conclusions: Surgical patients with NEPL at LSH were less likely to be readmitted than those at non-LSH. Given that LSH care for more patients with NEPL, they may be better equipped to serve a linguistically diverse population. Elucidating the reasons for readmission rate differences between LSH and non-LSH could inform surgical care for patients with NEPL at all hospitals.