title: Use of interpreters by physicians for hospitalized limited English proficient patients and its impact on patient outcomes.
abstract: BACKGROUND
  Few studies have examined the impact of inpatient interpreter use for limited English proficient (LEP) patients on length of stay (LOS), 30-day post discharge emergency department (ED) visits and 30-day hospital readmission rates for LEP patients.
  
  
  METHODS
  A retrospective cohort analysis was conducted of all hospitalized patients admitted to the general medicine service at a large academic center. For patients self-reported as LEP, use of interpreters during each episode of hospitalization was categorized as: 1) interpreter used by non-MD (i.e., nurse); 2) interpreter used by a non-Hospitalist MD; 3) interpreter used by Hospitalist; and 4) no interpreter used during hospitalization. We examined the association of English proficiency and interpreter use on outcomes utilizing Poisson and logistic regression models.
  
  
  RESULTS
  Of 4,224 patients, 564 (13 %) were LEP. Of these LEP patients, 65.8 % never had a documented interpreter visit, 16.8 % utilized an interpreter with a non-MD, 12.6 % utilized an interpreter with a non-Hospitalist MD and 4.8 % utilized an interpreter with a hospitalist present. In adjusted models, compared to English speakers, LEP patients with no interpreters had significantly shorter LOS. There were no differences in readmission rates and ED utilization between LEP and English-speaking patients. Compared to LEP patients with no interpreter use, those who had a physician use an interpreter had odds for a longer LOS, but there was no difference in odds of readmission or ED utilization.
  
  
  CONCLUSIONS
  Academic hospital clinician use of interpreters remains highly variable and physicians may selectively be using interpreters for the sickest patients.
authors: Department of General Medicine, Mongan Institute for Health Policy, and Disparities Solutions Center, Massachusetts General Hospital, Boston, MA, USA, llopez1@partners.org.
authors: Lenny
authors: L
authors: López
authors: Fátima
authors: F
authors: Rodriguez
authors: Diego
authors: D
authors: Huerta
authors: Jane
authors: J
authors: Soukup
authors: Leroi
authors: L
authors: Hicks
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003144:Communication Barriers; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D007297:Inpatients; D007802:Language; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019303:Multilingualism; D063868:Patient Outcome Assessment; D010359:Patient Readmission; D010817:Physician-Patient Relations; D012189:Retrospective Studies