P3.187: Language Other than English is a Risk Factor for Readmission of Pediatric Patients

Background: In the setting of the increasingly diverse population of the United States, there have been known challenges in communicating with patients who speak Languages Other than English (LOE) in the medical setting, leading to disparities in their care. There have been particular challenges appreciated in discharge planning and discharge communication. There exists a gap in demonstrating the impact language has on the discharge of pediatric patients. The purpose of this study is to understand the impact of language other than English on safe discharge planning by evaluating readmission as a marker of effective discharge coordination.

Methods: A chart review of the electronic medical record was performed by evaluating information from all encounters at the University of Maryland Children’s Hospital to the Pediatric Intensive Care Unit, Pediatric Progressive Care Unit, Pediatric Emergency Department, and Neonatal Intensive Care Unit from 2017-2022 for patients 0 to 20 years old. Information collected included the patient's preferred language on admission (written or spoken), admission and discharge diagnosis, mortality prior to discharge, readmission or ED visits at 7 and 30 days after discharge, readmission diagnosis, and insurance type (public or private). A total of 24,919 charts were included; charts without documented preferred language or preference listed as ‘newborn’ were excluded. Specific diagnoses served as a marker of medical complexity, such as congenital cardiac conditions, epilepsy, chronic respiratory failure, and sickle cell disease. Readmission rates at 7 and 30 days after discharge were calculated and compared between patients with documented language preference of English and of languages other than English, with medical complexity evaluated as a confounding factor. The data was analyzed using Chi-square and logistic regression.

Results: The results demonstrated a statistically significant increased chance of readmission in patients with language preference other than English at 30 days for both medically complex and non-complex diagnoses. There was no increased chance of readmission at 7 days for language other than English patients with and without medical complexity. Patients with only medical complexity had statistically higher odds of readmission at both 7 and 30 days.

Conclusion: It is apparent that there are increased odds of readmission for patients who speak languages other than English within 30 days of discharge, regardless of medical complexity. Further investigation of encounters of pediatric patients who speak languages other than English is warranted to understand the factors contributing to presentation within 30 days of discharge, including insurance, access to care, progression of English proficiency over time, and use of interpreters or translation services upon discharge.