For patients presenting to the pediatric emergency department, those accompanied by caregivers preferring languages other than English are more likely to be undertriaged, according to a study published online May 16 in Pediatrics.
Christina R. Rojas, M.D., from the Children’s National Hospital in Washington, D.C., and colleagues conducted a retrospective cross-sectional study of patients aged younger than 21 years triaged as Emergency Severity Index level 4 or 5 (nonurgent) to the pediatric emergency department from Jan. 1, 2019, through Jan. 31, 2021. Differences in undertriage, defined by indicators of hospital admission, significant emergency department resource use, or return visits with admission, were examined based on caregiver language preference.
The researchers found that 19.8 percent of the 114,266 emergency department visits included in the study represented patients with caregivers preferring languages other than English. Compared with those with caregivers preferring English, these children were more likely to experience undertriage (3.7 percent [English] versus 4.6 percent [Spanish] versus 5.9 percent [other languages]; odds ratios, 1.3 and 1.6 for Spanish versus English and other languages versus English, respectively). After adjustment for sex, insurance, mode of arrival, and clustering by triage nurse, the differences persisted (adjusted odds ratios, 1.3 and 1.6 for Spanish versus English and other languages versus English, respectively).
“Pediatric patients with caregivers who prefer languages other than English are more likely to be undertriaged in the pediatric emergency department,” the authors write. “These novel results provide important insights into the systemic inequities that exist for this population in health care.”
Christina R. Rojas et al, Undertriage for Children With Caregivers Preferring Languages Other Than English, Pediatrics (2023). DOI: 10.1542/peds.2022-059386
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