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Int. J. Environ. Res. Public Health 2014, 11(12), 13017-13034; doi:10.3390/ijerph111213017

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

1
Truven Health Analytics, 7700 Old Georgetown Road Suite 650, Bethesda, MD 20814, USA
2
Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850, USA
3
Barrett, Inc., 13943 Boquita Drive, Del Mar, CA 92014, USA
*
Author to whom correspondence should be addressed.
Received: 31 July 2014 / Revised: 25 November 2014 / Accepted: 9 December 2014 / Published: 12 December 2014
(This article belongs to the Special Issue Eliminating Health Disparities to Achieve Health Equity)
View Full-Text   |   Download PDF [718 KB, uploaded 12 December 2014]   |  

Abstract

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. View Full-Text
Keywords: health status disparities; language; inpatients; quality indicators; Whites; Blacks; Asians; Hispanics health status disparities; language; inpatients; quality indicators; Whites; Blacks; Asians; Hispanics
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Hines, A.L.; Andrews, R.M.; Moy, E.; Barrett, M.L.; Coffey, R.M. Disparities in Rates of Inpatient Mortality and Adverse Events: Race/Ethnicity and Language as Independent Contributors. Int. J. Environ. Res. Public Health 2014, 11, 13017-13034.

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