title: The effect of limited English proficiency on admission rates from a pediatric ED: stratification by triage acuity.
abstract: The objectives of this study were to determine the effect of Limited English Proficiency (LEP) visits and acuity status on admission rates from a pediatric ED. A retrospective cohort study was performed using a fully computerized medical record, which includes information on language spoken, triage acuity, and disposition. Data was collected on all patient visits from July 2002 to November 2002 from a tertiary-care pediatric ED. Admission rates and acuity status for LEP and non-LEP patients were compared. A total of 13,585 patient visits were identified, of which 12,416 fit the study criteria. There were 244 LEP patient visits, of which 206 were Spanish-speaking. There were 12,172 English-speaking patient visits. Compared with English-speaking visits, LEP visits were more likely to be triaged as high acuity (25.8% vs. 16.1%, P < .001). LEP patients were more likely to be admitted to the hospital (22.1% vs. 13%, P < .001). For high- and low-acuity patients, no significant differences in admission rates were seen between LEP and English-speaking patients. In contrast, moderate-acuity LEP visits showed a significantly increased admission rate compared to moderate acuity English visits (22.5% vs. 12.4%, P = .005). Similar trends were seen among Spanish-speaking LEP patients. Differences in medical disposition from the ED were found between English-speaking and LEP patient visits. There were higher rates of admission for LEP patients, particularly among moderate-acuity visits. This highlights disparities of care for this vulnerable population.
authors.affiliation: Departments of Pediatrics and Emergency Medicine, Emory University, Children's Healthcare of Atlanta, 1645 Tullie Circle, Atlanta, GA 30329, USA. alex_rogers@oz.ped.emory.edu
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Rogers
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Delgado
authors.forename: Harold K
authors.initials: HK
authors.lastname: Simon
mesh_terms: D002648:Child; D015331:Cohort Studies; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D005845:Georgia; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007802:Language; D008297:Male; D016347:Medical Records Systems, Computerized; D010343:Patient Admission / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014218:Triage / Q000706:statistics & numerical data