Limited English proficiency linked to higher hospital readmission rates for chronic disease patients, study finds

In predominantly English-speaking settings, patients with limited English proficiency and chronic conditions had higher rates of emergency department revisits and hospital readmissions than English-proficient patients, according to a research letter published in the Journal of the American Medical Association. 

Researchers reviewed data from 7,545 English-proficient patients and 2,336 limited-English proficiency patients between Jan.1, 2008, and March 21, 2016, at two Toronto hospitals. Only emergency department visits and readmissions for patients with acute conditions (pneumonia or hip fracture) and chronic conditions (chronic obstructive pulmonary disease or heart failure) were analyzed. 

Individuals with LEP were more likely to be older, female, have lower incomes and more comorbidities than EP patients, researchers say. LEP patients with heart failure had a 6 percent increased risk of a 30-day ED visit compared to EP patients. LEP patients also had higher readmission risks at 30 days (18.1 percent vs. 13.9 percent) and at 90 days (30.2 percent vs. 25.7 percent). LEP patients with COPD also had an increased readmission risk at 30 days (15.6 percent vs. 11.8 percent) and at 90 days (26.1 percent vs. 20.6 percent) but did not have significantly increased risk of a 30-day ED visit. 

There was no significant difference between emergency department visits or readmissions in LEP and EP patients with acute conditions.

LEP patients with COPD and heart failure reported poorer comprehension of discharge instructions, lower medication compliance and difficult care transitions, researchers found. 

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