title: The Effect of Limited English Proficiency on Pediatric Hospital Readmissions.
abstract: The relationship between limited English proficiency (LEP) and worse pediatric health outcomes is well documented.
  
  
  
  To determine the relationship between LEP status and pediatric hospital readmissions.
  
  
  
  We performed a retrospective cohort analysis of children ≤ 18 years old admitted to a tertiary children's hospital from 2008 to 2014. The main exposure was LEP status. Independent variables included sex, age, race/ethnicity, insurance, median household income, surgical/medical status, severity of illness (SOI), the presence of a complex chronic condition, and length of stay. Primary outcome measures were 7- and 30-day readmission.
  
  
  
  From 67 473 encounters, 7- and 30-day readmission rates were 3.9% and 8.2%, respectively. LEP patients were more likely to be younger, poorer, and Hispanic; have lower SOI; and government-subsidized insurance. Adjusted odds for 7- or 30-day readmission for LEP versus English-proficient (EP) patients were 1.00 (P = .99) and 0.97 (P = .60), respectively. Hispanic ethnicity (adjusted odds ratio [aOR]: 1.26 [P = .002] and 1.14 [P = .02]), greater SOI (aOR: 1.04 [P < .001] and 1.05 [P < .001]), and the presence of a complex chronic condition (aOR: 2.31 [P < .001] and 3.03 [P < .001]) were associated with increased odds of 7- and 30-day readmission, respectively. White LEP patients had increased odds of 7- and 30-day readmission compared with white EP patients (aOR: 1.46 [P = .006] and 1.32 [P = .007]) and the poorest LEP patients had increased odds of 7- and 30-day readmission compared with the poorest EP patients (aOR: 1.77 [P = .04] and 2.00 [P < .001]).
  
  
  
  This is the first large study evaluating the relationship between LEP and pediatric hospital readmission. There was no increased risk of readmission in LEP patients compared with EP patients.
authors.affiliation: Divisions of Pediatric Critical Care Medicine and mju@stanford.edu.
authors.forename: Mindy
authors.initials: M
authors.lastname: Ju
authors.affiliation: Divisions of Pediatric Critical Care Medicine and.
authors.forename: Nathan
authors.initials: N
authors.lastname: Luna
authors.affiliation: Pediatric Gastroenterology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.
authors.forename: K T
authors.initials: KT
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003144:Communication Barriers; D005006:Ethnicity; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology*; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D000069342:Medical Overuse / Q000517:prevention & control / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D014481:United States / Q000453:epidemiology