Mapping Segregation Patterns of Hospital Care among Patients with Limited English Proficiency.

Autor: Sliwinski K; Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA, USA. kssli@upenn.edu.; Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, USA. kssli@upenn.edu., Ancheta AJ; National Clinician Scholars Program, Craig-Dalsimer Division of Adolescent Medicine, Leonard Davis Institute of Health Economics, University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, PA, USA., Muir KJ; Center for Health Outcomes and Policy Research, School of Nursing, National Clinician Scholars Program, University of Pennsylvania, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA., Lasater KB; Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Jazyk: angličtina
Zdroj: Journal of immigrant and minority health [J Immigr Minor Health] 2024 Sep 13. Date of Electronic Publication: 2024 Sep 13.
DOI: 10.1007/s10903-024-01630-5
Abstrakt: Individuals with limited English proficiency (LEP) are disproportionately more likely to experience suboptimal care outcomes compared to English-proficient individuals, attributed to multi-level social determinants of health, including the quality of the hospital where LEP patients are more likely to receive care. Evidence demonstrates that racial minority patients are more often admitted to lower-quality hospitals serving high proportions of minority patients, despite living closer to higher-quality hospitals. Less is known about where individuals with LEP reside, where they seek hospital care, and the quality of care in these hospitals. Using Geographic Information Systems (GIS) methods, we developed a density map characterizing residential patterns of the LEP population across zip code tabulation areas in New Jersey and designated hospitals as high, middle, or low-LEP volume. We described differences in 30-day hospital wide readmission rates for hospitals across varying LEP volume status using Centers for Medicare and Medicaid Services Hospital Care Compare Data. Most hospitals in ZCTAs with higher LEP populations serve a high proportion of LEP patients (i.e. their patients' demographics are reflective of the community in which they are located). However, our results also show instances in which LEP patients may be forgoing receiving care at closer hospitals to instead receive care at further-distanced, high-LEP volume hospitals. significant. High-LEP volume hospitals have higher 30-day hospital wide readmission rates (20.1%) compared to middle (15%) and low (11.3%)-LEP volume hospitals (p < .001), indicating lower quality of care within high-LEP volume hospitals.
(© 2024. The Author(s).)
Databáze: MEDLINE
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