title: Identifying families with limited English proficiency using a capture-recapture approach.
abstract: OBJECTIVE
  Health providers need reliable estimates of the number of families with limited English proficiency (LEP) to assess language need and language service provision. Hospitals often lack reliable language screening tools and fail to provide interpretation for LEP families. The objective of this study was to develop a simple audit tool to more accurately identify LEP patients and families.
  
  
  METHODS
  We conducted a cross-sectional analysis of a retrospective cohort of patients admitted to a large pediatric hospital between July 1 and December 31, 2009. We used a "capture-recapture" approach to develop a simple audit tool to measure language screening, determine the rate of language interpretation, and estimate the number of LEP families. The captures were based on 2 independent sources: (1) language need identified at registration and (2) request for interpretation during hospital admission. Assuming a closed population, we estimated the number of LEP families missed by both captures.
  
  
  RESULTS
  During the study period, 6887 patients were admitted for care. There were 948 LEP families identified at registration and 847 families received interpretation at least once during hospital admission. We determined that the "ascertainment corrected" number of LEP families was 1031 (95% confidence interval: 1022-1040). The number of patients who had been "missed" by both methods was 15 (95% confidence interval: 7-24). Only 76% of LEP patients were identified in both data sources.
  
  
  CONCLUSIONS
  A simple language audit tool can be used to determine language need, rates of interpretation, and unmet demand for language services, even when both sources of data are incomplete.
authors.affiliation: Center for Diversity and Health Equity, Seattle Children's Hospital, Seattle, Washington;
authors.forename: Adrian
authors.initials: A
authors.lastname: Boscolo-Hightower
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Rafton
authors.forename: Michelle
authors.initials: M
authors.lastname: Tolman
authors.forename: Chuan
authors.initials: C
authors.lastname: Zhou
authors.forename: Beth E
authors.initials: BE
authors.lastname: Ebel
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D003144:Communication Barriers; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility; D006302:Health Services Research; D006801:Humans; D007223:Infant; D007802:Language; D008297:Male; D019303:Multilingualism; D020380:Needs Assessment; D012189:Retrospective Studies; D055815:Young Adult
keywords: Latino; communication barriers; health care disparities; health literacy; hospitalized child; language services; quality improvement; research methods; screening tool