Disparities in Rates of Inpatient Mortality and Adverse Events: Race/Ethnicity and Language as Independent Contributors

Patients with limited English proficiency have known limitations accessing health care, but differences in hospital outcomes once access is obtained are unknown. We investigate inpatient mortality rates and obstetric trauma for self-reported speakers of English, Spanish, and languages of Asia and t...

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Main Authors: Anika L. Hines, Roxanne M. Andrews, Ernest Moy, Marguerite L. Barrett, Rosanna M. Coffey
Format: Article
Language:English
Published: MDPI AG 2014-12-01
Series:International Journal of Environmental Research and Public Health
Subjects:
Online Access:http://www.mdpi.com/1660-4601/11/12/13017
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spelling doaj-e10c7b8ba4ca4c58b116decf73a5b6992020-11-24T23:57:31ZengMDPI AGInternational Journal of Environmental Research and Public Health1660-46012014-12-011112130171303410.3390/ijerph111213017ijerph111213017Disparities in Rates of Inpatient Mortality and Adverse Events: Race/Ethnicity and Language as Independent ContributorsAnika L. Hines0Roxanne M. Andrews1Ernest Moy2Marguerite L. Barrett3Rosanna M. Coffey4Truven Health Analytics, 7700 Old Georgetown Road Suite 650, Bethesda, MD 20814, USAAgency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850, USAAgency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850, USABarrett, Inc., 13943 Boquita Drive, Del Mar, CA 92014, USATruven Health Analytics, 7700 Old Georgetown Road Suite 650, Bethesda, MD 20814, USAPatients with limited English proficiency have known limitations accessing health care, but differences in hospital outcomes once access is obtained are unknown. We investigate inpatient mortality rates and obstetric trauma for self-reported speakers of English, Spanish, and languages of Asia and the Pacific Islands (API) and compare quality of care by language with patterns by race/ethnicity. Data were from the United States Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, 2009 State Inpatient Databases for California. There were 3,757,218 records. Speaking a non-English principal language and having a non-White race/ethnicity did not place patients at higher risk for inpatient mortality; the exception was significantly higher stroke mortality for Japanese-speaking patients. Patients who spoke API languages or had API race/ethnicity had higher risk for obstetric trauma than English-speaking White patients. Spanish-speaking Hispanic patients had more obstetric trauma than English-speaking Hispanic patients. The influence of language on obstetric trauma and the potential effects of interpretation services on inpatient care are discussed. The broader context of policy implications for collection and reporting of language data is also presented. Results from other countries with and without English as a primary language are needed for the broadest interpretation and generalization of outcomes.http://www.mdpi.com/1660-4601/11/12/13017health status disparitieslanguageinpatientsquality indicatorsWhitesBlacksAsiansHispanics
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language English
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sources DOAJ
author Anika L. Hines
Roxanne M. Andrews
Ernest Moy
Marguerite L. Barrett
Rosanna M. Coffey
spellingShingle Anika L. Hines
Roxanne M. Andrews
Ernest Moy
Marguerite L. Barrett
Rosanna M. Coffey
Disparities in Rates of Inpatient Mortality and Adverse Events: Race/Ethnicity and Language as Independent Contributors
International Journal of Environmental Research and Public Health
health status disparities
language
inpatients
quality indicators
Whites
Blacks
Asians
Hispanics
author_facet Anika L. Hines
Roxanne M. Andrews
Ernest Moy
Marguerite L. Barrett
Rosanna M. Coffey
author_sort Anika L. Hines
title Disparities in Rates of Inpatient Mortality and Adverse Events: Race/Ethnicity and Language as Independent Contributors
title_short Disparities in Rates of Inpatient Mortality and Adverse Events: Race/Ethnicity and Language as Independent Contributors
title_full Disparities in Rates of Inpatient Mortality and Adverse Events: Race/Ethnicity and Language as Independent Contributors
title_fullStr Disparities in Rates of Inpatient Mortality and Adverse Events: Race/Ethnicity and Language as Independent Contributors
title_full_unstemmed Disparities in Rates of Inpatient Mortality and Adverse Events: Race/Ethnicity and Language as Independent Contributors
title_sort disparities in rates of inpatient mortality and adverse events: race/ethnicity and language as independent contributors
publisher MDPI AG
series International Journal of Environmental Research and Public Health
issn 1660-4601
publishDate 2014-12-01
description Patients with limited English proficiency have known limitations accessing health care, but differences in hospital outcomes once access is obtained are unknown. We investigate inpatient mortality rates and obstetric trauma for self-reported speakers of English, Spanish, and languages of Asia and the Pacific Islands (API) and compare quality of care by language with patterns by race/ethnicity. Data were from the United States Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, 2009 State Inpatient Databases for California. There were 3,757,218 records. Speaking a non-English principal language and having a non-White race/ethnicity did not place patients at higher risk for inpatient mortality; the exception was significantly higher stroke mortality for Japanese-speaking patients. Patients who spoke API languages or had API race/ethnicity had higher risk for obstetric trauma than English-speaking White patients. Spanish-speaking Hispanic patients had more obstetric trauma than English-speaking Hispanic patients. The influence of language on obstetric trauma and the potential effects of interpretation services on inpatient care are discussed. The broader context of policy implications for collection and reporting of language data is also presented. Results from other countries with and without English as a primary language are needed for the broadest interpretation and generalization of outcomes.
topic health status disparities
language
inpatients
quality indicators
Whites
Blacks
Asians
Hispanics
url http://www.mdpi.com/1660-4601/11/12/13017
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