Emergency Department Presentations in Culturally and Linguistically Diverse Populations Based on Preferred Language. Characteristics and Outcomes in New South Wales Australia

Objective

To explore demographic, clinical characteristics and predictors of outcomes of patients presenting to the emergency department (ED) from various cultural groups using preferred language as a proxy marker of culturally and linguistically diverse populations (CALD).

Methods

Multicentre data linkage analysis from NSW Australia. ED presentations were identified from the Emergency Department Data Collection containing individual person level data linked deterministically across datasets through a unique master linkage key from around 180 recognised public hospitals. The outcome of interest was ED length of stay and 30-day all-cause mortality following ED presentation.

Results

A total of 3,029,492 ED presentations were analysed, of which 336,414 (11%) indicated a non-English preferred language. Overall, non-English preferred language groups were associated with longer ED length of stay for both admitted and discharged patients and higher 30-day mortality (1.2% vs. 2.0%, p < 0.001). There were marked demographic and clinical differences in characteristics across all non-English preferred language groups. After adjusting for these differences across preferred language groups, the Cantonese preferred language group was associated with a small increased risk of 30-day mortality with an adjusted OR: 1.28 (95% CI: 1.05–1.55, p = 0.01).

Conclusion

There were substantial differences with respect to age, presentation characteristics and outcomes across patients from major non-English preferred language groups presenting to ED. Such groups should not be analysed as a single CALD group when examining access and outcomes of ED care, and differences in reported outcomes require further exploration. Any differences in outcomes such as mortality need to be interpreted with caution due to unknown and unmeasured confounders.