Limited English Proficient Patient Visits and Emergency Department Admission Rates for Ambulatory Care Sensitive Conditions in California: a Retrospective Cohort Study.
Limited English Proficient Patient Visits and Emergency Department Admission Rates for Ambulatory Care Sensitive Conditions in California: a Retrospective Cohort Study.
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加利福尼亚州流动护理敏感病症的英语熟练患者就诊和急诊科入院率有限：一项回顾性队列研究。
DOI：
10.1007/s11606-020-06523-5
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发表时间：
2021
影响因子：
5.7
通讯作者：
Hanchate,AmreshD
中科院分区：
文献类型：
--
作者：
Schulson,Lucy;Lin,Meng-Yun;Paasche-Orlow,MichaelK;Hanchate,AmreshD
背景英语水平有限（LEP）患者因门诊护理敏感性疾病（ACSC）而进入急诊科（ED）就诊的风险知之甚少。患者，并检查这些比率在LEP患者比例高与低的医院中的变化。设计加州2017年住院患者的回顾性队列研究和艾德行政数据采集者年龄≥ 18岁的社区居民，无妊娠或分娩的初步诊断。LEP患者有一个主要的语言以外的英语。Main MeasuresWe使用了一系列的线性概率模型与增量集的协变量，包括患者的人口统计学，主要诊断，Elixhauser合并症，检查入院率的LEP与EP患者的访问。然后，我们增加了一个交互作用协变量，高与低LEP服务医院。我们估计模型与医院水平的随机effects.Key ResultsThese分析包括9，641，689艾德访问; 14.7%是LEP患者。. LEP患者ACSC艾德访视的住院率高于EP患者（26.2% vs. 25.2; p值<0.001）。校正后的入院率无统计学显著性（27.3%[95% CI 25.4 - 29.3%] vs. 26.2%[95% CI 24.3 - 28.1%]）。对于COPD，差异具有显著性（36.8%[95% CI 35.0 - 38.6%] vs. 33.3%[95% CI 31.7 - 34.9%]）。LEP与EP访问调整后的入院率的差异并没有显着差异，在高与低LEP-serving hospital.ConclusionsIn调整后的分析，LEP是不是一个危险因素，为大多数ACSC入院。这一发现在高和低LEP服务医院都观察到。
BackgroundLittle is known about the risk of admission for emergency department (ED) visits for ambulatory care sensitive conditions (ACSCs) by limited English proficient (LEP) patients.ObjectiveEstimate admission rates from ED for ACSCs comparing LEP and English proficient (EP) patients and examine how these rates vary at hospitals with a high versus low proportion of LEP patients.DesignRetrospective cohort study of California’s 2017 inpatient and ED administrative dataParticipantsCommunity-dwelling individuals ≥ 18 years without a primary diagnosis of pregnancy or childbirth. LEP patients had a principal language other than English.Main MeasuresWe used a series of linear probability models with incremental sets of covariates, including patient demographics, primary diagnosis, and Elixhauser comorbidities, to examine admission rate for visits of LEP versus EP patients. We then added an interaction covariate for high versus low LEP-serving hospital. We estimated models with and without hospital-level random effects.Key ResultsThese analyses included 9,641,689 ED visits; 14.7% were for LEP patients. . Observed rate of admission for all ACSC ED visits was higher for LEP than for EP patients (26.2% vs. 25.2;pvalue < .001). Adjusted rate of admission was not statistically significant (27.3% [95% CI 25.4–29.3%] vs. 26.2% [95% CI 24.3–28.1%]). For COPD, the difference was significant (36.8% [95% CI 35.0–38.6%] vs. 33.3% [95% CI 31.7–34.9%]). Difference in adjusted admission rate for LEP versus EP visits did not differ in high versus low LEP-serving hospitals.ConclusionsIn adjusted analyses, LEP was not a risk factor for admission for most ACSCs. This finding was observed in both high and low LEP-serving hospitals.