title: Parental Language and Return Visits to the Emergency Department After Discharge.
abstract: OBJECTIVE
  Return visits to the emergency department (ED) are used as a marker of quality of care. Limited English proficiency, along with other demographic and disease-specific factors, has been associated with increased risk of return visit, but the relationship between language, short-term return visits, and overall ED use has not been well characterized.
  
  
  METHODS
  This is a planned secondary analysis of a prospective cohort examining the ED discharge process for English- or Spanish-speaking parents of children aged 2 months to 2 years with fever and/or respiratory illness. At 1 year after the index visit, a standardized chart review was performed. The primary outcome was the number of ED visits within 72 hours of the index visit. Multivariable logistic regression was used to examine the relative importance of predictor variables and adjust for confounders.
  
  
  RESULTS
  There were 202 parents eligible for inclusion, of whom 23% were Spanish speaking. In addition, 6.9% of the sample had a return visit within 72 hours. After adjustment for confounders, Spanish language was associated with return visit within 72 hours (odds ratio, 3.49; 95% confidence interval, 1.02-11.90) but decreased risk of a second visit within the year (odds ratio, 0.28; 95% confidence interval, 0.12-0.66).
  
  
  CONCLUSIONS
  Spanish-speaking parents are at an increased risk of 72-hour return ED visit but do not seem to be at increased risk of ED use during the year after their ED visit.
authors.affiliation: From the *Children's Hospital of Philadelphia, Philadelphia, PA; †Children's Hospital Boston; and ‡Harvard Affiliated Emergency Medicine Residency (BWH/MGH), Boston, MA; and §The Hospital for Sick Children; and ∥Department of Pediatrics, University of Toronto, Toronto, Canada.
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Samuels-Kalow
authors.forename: Anne M
authors.initials: AM
authors.lastname: Stack
authors.forename: Kendra
authors.initials: K
authors.lastname: Amico
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Porter
mesh_terms: D002675:Child, Preschool; D003144:Communication Barriers; D032882:Comprehension; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005334:Fever / Q000175:diagnosis / Q000453:epidemiology; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007802:Language; D017063:Outcome Assessment, Health Care; D010290:Parents; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data* / Q000639:trends; D011446:Prospective Studies; D011787:Quality of Health Care; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000453:epidemiology