Length of hospital stay varies with native language

Hospitalized children from Spanish-speaking families are likely to stay in the hospital for a longer time in association with a serious or sentinel event after admission than English speakers. Spanish-speaking children also may be more likely to experience such an event, according to an analysis of almost 34,000 admissions to a large children’s hospital during a 2-year period. Serious and sentinel events were rare (only 87 in total), yet 14% of those who had them spoke Spanish, although Spanish-speaking patients represented only 8% of total patients.

Having an adverse event was independently associated with an almost 5-fold increase in length of stay. Among patients who had an adverse event, those whose families spoke Spanish had significantly longer hospital stays than children whose families spoke English (26 days vs 12.7 days, respectively). Finally, the length of stay for English-speaking children with a serious adverse event was 5 times longer than that of English-speaking children without such an event, whereas for Spanish-speaking children the mean length of stay was about 10 times longer in children with a serious adverse event compared with those without one (Lion KC, et al. Hosp Pediatr. 2013;3[3]:219-225).

COMMENTARY  The investigation found that children from Spanish-speaking families had increased likelihood of a serious or sentinel event, although the finding was not quite statistically significant. These researchers also report that use of qualified interpreters is “the rule” in their institution. Had the study been conducted in hospitals and practices where physicians and staff are less focused on using trained interpreters, their findings may have been even more convincing.

Language barriers are emerging as a significant and fixable cause of adverse outcomes in pediatrics. Only 55% of pediatricians surveyed say that they use formal interpreters to communicate to patients with limited English proficiency, a minimal increase from 50% in 2004 (Decamp LR, et al. Pediatrics. 2013;132[2]:e396-e406). -Michael Burke, MD

MS FREEDMAN is a freelance medical editor and writer in New Jersey. DR BURKE, section editor for Journal Club, is chairman of the Department of Pediatrics at Saint Agnes Hospital, Baltimore, Maryland. He is a contributing editor for Contemporary Pediatrics. They have nothing to disclose in regard to affiliations with or financial interests in any organizations that may have an interest in any part of this article.

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