Observational study on resource utilisation of patients with limited English proficiency (LEP) at a high-LEP serving community hospital emergency department

Abstract

Communication barriers often result in healthcare disparities. Language barriers in patients with limited English proficiency (LEP) frequently results in higher healthcare expenditures and potentially poorer patient-centred outcomes. Therefore, we decided to assess resource utilisation of patients with LEP at our high-LEP serving community hospital emergency department (ED) in Canada. Specifically, we examined whether LEP patients have a higher rate of CT utilisation and/or a higher rate of hospital admission from the ED. We enrolled 100 patients who presented to the ED in our study. Each patient's English proficiency was rated. We classified 31 patients as LEP patients and 69 patients as non-LEP patients. Within the LEP patients' group, 13 out of 31 patients (42%) received a CT scan, while in the non-LEP patients' group, 30 out of 69 patients (43%) received a CT scan. In addition, 28 out of 31 patients (90%) from the LEP patients' group were admitted to the hospital after the initial ED consultation, while in the non-LEP patients' group, 51 out of 69 patients (74%) were admitted. We did not find a difference in CT scan utilisation between LEP and non-LEP patients (p=0.89). Although there is a trend towards a higher hospital admission rate in LEP patients, our finding was not statistically significant (p=0.062).