Post-discharge Outcomes and Healthcare Utilization Among Hispanic/Latinx Injury Survivors: English Language Proficiency Matters.

Autor:	Valverde M; Department of Surgery, Brigham And Women's Hospital, Boston, MA.; Tufts University School of Medicine, Boston, MA., Ilkhani S; Department of Surgery, Brigham And Women's Hospital, Boston, MA., Pinkes N; Department of Surgery, Brigham And Women's Hospital, Boston, MA., Froehle L; Department of Surgery, Boston Medical Center, Boston, MA., Ortega G; Department of Surgery, Brigham And Women's Hospital, Boston, MA., Hwabejire JO; Department of Surgery, Massachusetts General Hospital, Boston, MA., Sanchez SE; Department of Surgery, Boston Medical Center, Boston, MA., Haider AH; Department of Surgery, Brigham And Women's Hospital, Boston, MA., Salim A; Department of Surgery, Brigham And Women's Hospital, Boston, MA., Anderson GA; Department of Surgery, Brigham And Women's Hospital, Boston, MA., Herrera-Escobar JP; Department of Surgery, Brigham And Women's Hospital, Boston, MA.
Jazyk:	angličtina
Zdroj:	Annals of surgery [Ann Surg] 2024 Aug 23. Date of Electronic Publication: 2024 Aug 23.
DOI:	10.1097/SLA.0000000000006512
Abstrakt:	Objective: We sought to compare post-discharge outcomes and healthcare utilization between English-speaking non-Hispanic White (NHW), English-speaking Hispanic/Latinx (ESHL), and Spanish-speaking Hispanic/Latinx (SSHL) survivors of traumatic injury. Background: While there is evidence of racial and ethnic disparities in healthcare utilization and post-discharge outcomes after injury, the role of English language proficiency in these disparities remains unclear. Methods: Moderate to severely injured adults from three level-1 trauma centers completed an interview in English or Spanish between 6-12 months post-injury to assess physical health-related quality of life (SF-12-PCS), return to work, and post-discharge healthcare utilization. The language used in the interview was used as a proxy for English-language proficiency, and participants were categorized as either NHW (reference), ESHL, or SSHL. Multivariable regression models estimated independent associations between language and race/ethnicity with SF-12-PCS, return to work, and post-discharge healthcare utilization outcomes. Results: 3,304 injury survivors were followed: 2,977 (90%) NHW, 203 (6%) ESHL, and 124 (4%) SSHL. In adjusted analyses, no significant differences were observed between ESHL and NHW injury survivors for any outcomes at 6-12 months post-injury. However, SSHL injury survivors exhibited a lower mean SF-12-PCS (41.6 vs. 38.5), -3.07 (95% CI=-5.47, -0.66; P=0.012), decreased odds of returning to work (OR=0.47; CI=0.27 to 0.81; P=0.007), and were less likely to engage in non-injury related outpatient visits, such as primary care visits (OR=0.45; 95% CI 0.28, 0.73; P=0.001), compared to NHW patients. Conclusion: Hispanic/Latinx injury survivors have worse post-discharge outcomes and lower non-injury-related healthcare utilization than NHW if they have limited English-language proficiency. Addressing LEP-related barriers to care could help mitigate outcome and healthcare utilization disparities among Hispanic/Latinx injury survivors. Competing Interests: The authors report no conflicts of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu