Disparities in Pediatric Emergency Department Length of Stay and Utilization Associated with Primary Language

Lowe, Jeremiah T.

Full Metadata

Overview

Year:: 2021
Contributor:: Lowe, Jeremiah T (creator); Zonfrillo, Mark (Advisor); Brown University. Biology and Medicine: Population Medicine (sponsor)
Genre:: theses
Subject:: Pediatrics; Emergency medicine; Health disparities,
Extent:: vii, 23 p.

Files

Description

Abstract:: Objectives To investigate the association between primary language and length of stay (LOS) in the pediatric emergency department (ED) within the context of known disparities impacting healthcare experiences and outcomes for patients with language barriers. Methods We conducted a retrospective cohort study of consecutive encounters of patients presenting to, and discharged from, an urban pediatric ED from May 2015 through April 2018. Encounters were grouped into English primary language (EPL), Spanish (SPL), and other (OPL). Mean LOS comparisons were stratified by emergency severity index (ESI). Bivariate and multivariate analyses were employed to examine the relationship between LOS and variables including age, sex, race/ethnicity, insurance, and time of presentation. Results A total of 139,163 encounters were included. A higher proportion of SPL and OPL encounters were characterized as lower ESI acuity compared to EPL. Significantly longer LOS for SPL and OPL encounters was observed in the two lower acuity strata. The ESI 4–5 stratum demonstrated the greatest LOS disparity between EPL, SPL, and OPL (94 versus 103 versus 103 minutes, respectively; p < .001). In the highest acuity stratum, ESI 1–2, there was a non-significant trend towards longer LOS among EPL encounters (p = .08). The multivariate model accounted for 24% of LOS variance, but effect sizes were small for all variables except for ESI and age. Conclusions Patients with Spanish or other non-English primary language who were triaged to lower acuity ESI levels experienced longer LOS in the pediatric ED than English-speaking counterparts. They also utilized the ED more frequently for low acuity issues, possibly reflecting disparities in access to primary care.
Notes:: Thesis (Sc. M.)--Brown University, 2021

Content

Citation

Lowe, Jeremiah T., "Disparities in Pediatric Emergency Department Length of Stay and Utilization Associated with Primary Language" (2021). Biology and Medicine Theses and Dissertations. Brown Digital Repository. Brown University Library. https://repository.library.brown.edu/studio/item/bdr:keebb9ct/

Relations

Collection:

Biology and Medicine Theses and Dissertations

Theses and Dissertations for the Biology and Medicine department.
...