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

Anika L. Hines, Roxanne M. Andrews, Ernest Moy, Marguerite L. Barrett and Rosanna M. Coffey
Additional contact information
Anika L. Hines: Truven Health Analytics, 7700 Old Georgetown Road Suite 650, Bethesda, MD 20814, USA
Roxanne M. Andrews: Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850, USA
Ernest Moy: Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850, USA
Marguerite L. Barrett: Barrett, Inc., 13943 Boquita Drive, Del Mar, CA 92014, USA
Rosanna M. Coffey: Truven Health Analytics, 7700 Old Georgetown Road Suite 650, Bethesda, MD 20814, USA

IJERPH, 2014, vol. 11, issue 12, 1-18

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.

Keywords: health status disparities; language; inpatients; quality indicators; Whites; Blacks; Asians; Hispanics (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2014
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