Language affects length of stay in emergency departments in Queensland public hospitals

doi:10.5847/wjem.j.issn.1920-8642.2013.01.001

Abstract

Abstract:

BACKGROUND: A long length of stay (LOS) in the emergency department (ED) associated with overcrowding has been found to adversely affect the quality of ED care. The objective of this study is to determine whether patients who speak a language other than English at home have a longer LOS in EDs compared to those whose speak only English at home.
METHODS: A secondary data analysis of a Queensland state-wide hospital EDs dataset (Emergency Department Information System) was conducted for the period, 1 January 2008 to 31 December 2010.
RESULTS: The interpreter requirement was the highest among Vietnamese speakers (23.1%) followed by Chinese (19.8%) and Arabic speakers (18.7%). There were significant differences in the distributions of the departure statuses among the language groups (Chi-squared=3236.88, P<0.001). Compared with English speakers, the Beta coefficient for the LOS in the EDs measured in minutes was among Vietnamese, 26.3 (95%CI: 22.1-30.5); Arabic, 10.3 (95%CI: 7.3-13.2); Spanish, 9.4 (95%CI: 7.1-11.7); Chinese, 8.6 (95%CI: 2.6-14.6); Hindi, 4.0 (95%CI: 2.2-5.7); Italian, 3.5 (95%CI: 1.6-5.4); and German, 2.7 (95%CI: 1.0-4.4). The final regression model explained 17% of the variability in LOS.
CONCLUSION: There is a close relationship between the language spoken at home and the LOS at EDs, indicating that language could be an important predictor of prolonged LOS in EDs and improving language services might reduce LOS and ease overcrowding in EDs in Queensland's public hospitals.

Key words: Emergency department, Language, Length of stay

Ibrahim Mahmoud, Xiang-yu Hou, Kevin Chu, Michele Clark. Language affects length of stay in emergency departments in Queensland public hospitals[J]. World Journal of Emergency Medicine, 2013, 4(1): 5-9.

Figures/Tables 4

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Languages	Departure status
Languages	Admitted/Referred (%)	Discharged (%)	Did not wait (%)	Died (%)	Total
English	697 169 (24)	1 984 087 (68.3)	221 551 (7.6)	2 397 (0.1)	2 905 204 (100)
Chinese^*	1 341 (26.4)	3 356 (66.0)	381 (7.5)	4 (0.1)	5 082 (100)
Vietnamese	893 (35.1)	1 478 (58.0)	173 (6.8)	3 (0.1)	2 547 (100)
Arabic	421 (18.8)	1 593 (71.1)	225 (10.0)	2 (0.1)	2 241 (100)
Spanish	629 (30.7)	1 285 (62.8)	129 (6.3)	4 (0.2)	2 047 (100)
Italian	981 (48.7)	976 (48.5)	55 (2.7)	1 (0.0)	2 013 (100)
Hindi	444 (29.0)	957 (62.5)	128 (8.4)	1 (0.1)	1 530 (100)
German	471 (36.8)	762 (59.5)	47 (3.7)	1 (0.1)	1 281 (100)
Other	10 649 (33.5)	18 962 (59.7)	2 062 (6.5)	113 (0.4)	31 786 (100)
Total	712 998 (24.1)	2 013 456 (68.2)	224 751 (7.6)	2 526 (0.1)	2 953 731 (100)

Main languages	Total no.	Interpreter required (%)
English only^*	1 984 087	386 (0.0)
Chinese^**	3 356	666 (19.8)
Vietnamese	1 478	342 (23.1)
Arabic	1 593	298 (18.7)
Spanish	1 285	208 (16.2)
Italian	976	114 (11.7)
Hindi	957	132 (13.8)
German	762	44 (5.8)

Main languages	OR (95%CI)	P
Reference group: English only
Chinese^*	14.5 (9.3-19.6)	0.000
Vietnamese	28.4 (24.5-32.3)	0.000
Arabic	14.4 (11.9-16.8)	0.000
Spanish	11.4 (9.3-13.5)	0.000
Italian	3.4 (1.5-5.3)	0.001
Hindi	4.1 (2.5-5.7)	0.000
German	2.0 (0.5-3.5)	0.01

Main languages	OR (95%CI)	P
Reference group: English only
Chinese^*	8.6 (2.6-14.6)	0.005
Vietnamese	26.3 (22.1-30.5)	0.000
Arabic	10.3 (7.3-13.2)	0.000
Spanish	9.4 (7.1-11.7)	0.000
Italian	3.5 (1.6-5.4)	0.001
Hindi	4.0 (2.2-5.7)	0.000
German	2.7 (1.0-4.4)	0.001

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