In-Hospital Patient Harm Across Linguistic Groups: A Retrospective Cohort Study of Home Care Recipients.
Journal
Journal of patient safety
ISSN: 1549-8425
Titre abrégé: J Patient Saf
Pays: United States
ID NLM: 101233393
Informations de publication
Date de publication:
01 01 2022
01 01 2022
Historique:
pubmed:
21
5
2020
medline:
24
2
2022
entrez:
21
5
2020
Statut:
ppublish
Résumé
Research examining the impact of language barriers on patient safety is limited. We conducted a population-based study to determine whether patients whose primary language is not English are more likely to experience harm when admitted to hospitals in Ontario, Canada. We used linked administrative health records to establish a retrospective cohort of home care recipients (from 2010 to 2015) who were subsequently admitted to hospital. Patient language (obtained from home care assessments) was coded as English, French, or other. Harmful events were identified using the Hospital Harm Indicator developed by the Canadian Institute for Health Information. We included 190,724 patients (156,186 Anglophones, 5,110 Francophones, and 29,428 Allophones). There was no significant difference in the unadjusted risk of harm for Francophones compared with Anglophones (relative risk [RR], 0.94; 95% confidence interval [CI], 0.87-1.02). However, Allophones were more likely to experience harm when compared with Anglophones (RR, 1.14; 95% CI, 1.10-1.18). The risk of harm was even greater for Allophones with low English proficiency (RR, 1.18; 95% CI, 1.13-1.24). After adjusting for potential confounders, Anglophones and Allophones were equally likely to experience harm of any type, but Allophones more likely to experience harm from infections and procedures. Patients whose primary language was not English or French were more likely to experience harm after admission to hospital, especially if they had low English proficiency. For these patients, the risk of harm from infections and procedures persisted in the adjusted analysis, but the overall risk of harm did not.
Identifiants
pubmed: 32433437
pii: 01209203-202201000-00034
doi: 10.1097/PTS.0000000000000726
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e196-e204Informations de copyright
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors disclose no conflict of interest.
Références
World Health Organization. Patient safety: making health care safer. 2017. Available at: https://apps.who.int/iris/bitstream/handle/10665/255507/WHO-HIS-SDS-2017.11-eng.pdf?sequence=1&isAllowed=y . Accessed November 1, 2019.
Canadian Institute for Health Information. Measuring patient harm in Canadian hospitals. 2016. Available at: https://secure.cihi.ca/free_products/cihi_cpsi_hospital_harm_en.pdf . Accessed June 1, 2018.
Slawomirski L, Auraaen A, Klazinga N. The economics of patient safety: strengthening a value-based approach to reducing patient harm at national level. Organisation for Economic Cooperation and Development. 2017. Available at: https://www.oecd.org/els/health-systems/The-economics-of-patient-safety-March-2017.pdf . Accessed November 1, 2019.
Canadian Patient Safety Institute. Safer healthcare now. 2019. Available at: https://www.patientsafetyinstitute.ca/en/About/Programs/SHN/Pages/default.aspx . Accessed September 2, 2019.
Assiri GA, Shebl NA, Mahmoud MA, et al. What is the epidemiology of medication errors, error-related adverse events and risk factors for errors in adults managed in community care contexts? A systematic review of the international literature. BMJ Open . 2018;8:e019101.
Matlow AG, Baker GR, Flintoft V, et al. Adverse events among children in Canadian hospitals: the Canadian Paediatric Adverse Events Study. CMAJ . 2012;184:E709–E718.
Bartlett G, Blais R, Tamblyn R, et al. Impact of patient communication problems on the risk of preventable adverse events in acute care settings. CMAJ . 2008;178:1555–1562.
John-Baptiste A, Naglie G, Tomlinson G, et al. The effect of English language proficiency on length of stay and in-hospital mortality. J Gen Intern Med . 2004;19:221–228.
Goldman RD, Amin P, Macpherson A. Language and length of stay in the pediatric emergency department. Pediatr Emerg Care . 2006;22:640–643.
Batista R, Prud’homme D, Hsu AT, et al. The health impact of living in a nursing home with a predominantly different spoken language. J Am Med Dir Assoc . 2019;20:1649–1651.
Rawal S, Srighanthan J, Vasantharoopan A, et al. Association between limited English proficiency and revisits and readmissions after hospitalization for patients with acute and chronic conditions in Toronto, Ontario, Canada. JAMA . 2019;322:1605–1607.
Karliner LS, Kim SE, Meltzer DO, et al. Influence of language barriers on outcomes of hospital care for general medicine inpatients. J Hosp Med . 2010;5:276–282.
Gallagher RA, Porter S, Monuteaux MC, et al. Unscheduled return visits to the emergency department: the impact of language. Pediatr Emerg Care . 2013;29:579–583.
Sarver J, Baker DW. Effect of language barriers on follow-up appointments after an emergency department visit. J Gen Intern Med . 2000;15:256–264.
Karliner LS, Auerbach A, Nápoles A, et al. Language barriers and understanding of hospital discharge instructions. Med Care . 2012;50:283–289.
Cohen AL, Rivara F, Marcuse EK, et al. Are language barriers associated with serious medical events in hospitalized pediatric patients? Pediatrics . 2005;116:575–579.
Lion KC, Rafton SA, Shafii J, et al. Association between language, serious adverse events, and length of stay among hospitalized children. Hosp Pediatr . 2013;3:219–225.
Hines AL, Andrews RM, Moy E, et al. 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.
Bowen S. The impact of language barriers on patient safety and quality of care. Société Santé en français. 2015. Available at: http://francosantesud.ca/wp-content/uploads/SSF-Bowen-S.-Language-Barriers-Study.pdf . Accessed June 1, 2019.
Sentell T, Chang A, Ahn HJ, et al. Maternal language and adverse birth outcomes in a statewide analysis. Women Health . 2016;56:257–280.
Jellinek-Cohen SP, Li M, Husk G. Enoxaparin dosing errors in the emergency department. World J Emerg Med . 2018;9:195–202.
Ben-Yehuda A, Bitton Y, Sharon P, et al. Risk factors for prescribing and transcribing medication errors among elderly patients during acute hospitalization: a cohort, case-control study. Drugs Aging . 2011;28:491–500.
Van Rosse F, Essink-Bot ML, Stronks K, et al. Ethnic minority patients not at increased risk of adverse events during hospitalisation in urban hospitals in the Netherlands: results of a prospective observational study. BMJ Open . 2014;4:e005527.
Wasserman M, Renfrew MR, Green AR, et al. Identifying and preventing medical errors in patients with limited english proficiency: key findings and tools for the field. J Healthc Qual . 2014;36:5–16.
Berthe-Aucejo A, Girard D, Lorrot M, et al. Evaluation of frequency of paediatric oral liquid medication dosing errors by caregivers: amoxicillin and josamycin. Arch Dis Child . 2016;101:359–364.
Inagaki E, Farber A, Kalish J, et al. Role of language discordance in complication and readmission rate after infrainguinal bypass. J Vasc Surg . 2017;66:1473–1478.
Canadian Patient Safety Institute. Safety at home: a Pan-Canadian Home Care Safety Study. 2013. Available at: https://www.patientsafetyinstitute.ca/en/toolsResources/Research/commissionedResearch/SafetyatHome/Documents/Safety%20At%20Home%20Care.pdf . Accessed June 1, 2018.
Long SJ, Brown KF, Ames D, et al. What is known about adverse events in older medical hospital inpatients? A systematic review of the literature. Int J Qual Health Care . 2013;25:542–554.
Yorkston K, Bourgeois M, Baylor C. Communication and aging. Phys Med Rehabil Clin N Am . 2010;21:309–319.
Morris J, Fries B, Bernabei R, et al. RAI-Home Care (RAI-HC) User’s Manual, Canadian Version, September 2010. Canadian Institute for Health Information. 2010. Available at: https://secure.cihi.ca/estore/productFamily.htm?pf=PFC1554&lang=en&media=0 . Accessed June 1, 2018.
Hsu AT, Manuel DG, Taljaard M, et al. Algorithm for predicting death among older adults in the home care setting: study protocol for the Risk Evaluation for Support: Predictions for Elder-life in the Community Tool (RESPECT). BMJ Open . 2016;6:e013666.
Stephenson A, Hux J, Tullis E, et al. Socioeconomic status and risk of hospitalization among individuals with cystic fibrosis in Ontario, Canada. Pediatr Pulmonol . 2011;46:376–384.
Mondor L, Maxwell CJ, Bronskill SE, et al. The relative impact of chronic conditions and multimorbidity on health-related quality of life in Ontario long-stay home care clients. Qual Life Res . 2016;25:2619–2632.
Pefoyo AJ, Bronskill SE, Gruneir A, et al. The increasing burden and complexity of multimorbidity. BMC Public Health . 2015;15:415.
Gruneir A, Bronskill SE, Maxwell CJ, et al. The association between multimorbidity and hospitalization is modified by individual demographics and physician continuity of care: a retrospective cohort study. BMC Health Serv Res . 2016;16:154.
Muggah E, Graves E, Bennett C, et al. The impact of multiple chronic diseases on ambulatory care use; a population based study in Ontario, Canada. BMC Health Serv Res . 2012;12:452.
Canadian Institute for Health Information. Discharge Abstract Database metadata (DAD). 2020. Available at: https://www.cihi.ca/en/discharge-abstract-database-metadata . Accessed March 7, 2020.
Canadian Institute for Health Information. Canadian coding standards for version 2018 ICD-10-CA and CCI. 2018. Available at: https://secure.cihi.ca/free_products/CodingStandards_v2018_EN.pdf . Accessed March 7, 2020.
Canadian Institute for Health Information. Measuring patient harm in Canadian hospitals: technical report. 2016. Available at: https://www.cihi.ca/sites/default/files/document/hospital_harm_technical_notes_en.pdf . Accessed June 1, 2018.
Canadian Institute for Health Information. Data quality study of the 2015–2016 Discharge Abstract Database: a focus on hospital harm. 2016. Available at: https://secure.cihi.ca/free_products/DAD_15_16_Reab_Report_EN.pdf . Accessed June 1, 2018.
Zou G. A modified Poisson regression approach to prospective studies with binary data. Am J Epidemiol . 2004;159:702–706.
Zou GY, Donner A. Extension of the modified Poisson regression model to prospective studies with correlated binary data. Stat Methods Med Res . 2013;22:661–670.
Yelland LN, Salter AB, Ryan P. Performance of the modified poisson regression approach for estimating relative risks from clustered prospective data. Am J Epidemiol . 2011;174:984–992.
Azur MJ, Stuart EA, Frangakis C, et al. Multiple imputation by chained equations: what is it and how does it work? Int J Methods Psychiatr Res . 2011;20:40–49.
Charlson M, Pompei P, Ales K, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis . 1987;40:373–383.
Morris JN, Fries BE, Morris SA. Scaling ADLs within the MDS. J Gerontol A Biol Sci Med Sci . 1999;54:M546–M553.
Morris JN, Fries BE, Mehr DR, et al. MDS Cognitive Performance Scale. J Gerontol . 1994;49:174–182.
Hirdes JP, Frijters DH, Teare GF. The MDS-CHESS scale: a new measure to predict mortality in institutionalized older people. J Am Geriatr Soc . 2003;51:96–100.
Statistics Canada. Data tables, 2016 Census. Available at: https://www12.statcan.gc.ca/census-recensement/2016/dp-pd/dt-td/Lp-eng.cfm?LANG=E&APATH=3&DETAIL=0&DIM=0&FL=A&FREE=0&GC=0&GID=0&GK=0&GRP=1&PID=0&PRID=10&PTYPE=109445&S=0&SHOWALL=0&SUB=888&Temporal=2016,2017&THEME=118&VID=0&VNAMEE=&VNAMEF= . Accessed December 1, 2019.
Government of Ontario. Government services in French. 2019. Available at: https://www.ontario.ca/page/government-services-french . Accessed October 6, 2019.
Government of Ontario. O. Reg. 398/93: designation of public services agencies. Available at: https://www.ontario.ca/laws/regulation/930398 . Accessed October 6, 2019.
Reaume M, Batista R, Talarico R, et al. Language discordance and patient harm: a retrospective cohort study of home care recipients in Ontario. Presented at: Canadian Society for Epidemiology and Biostatistics Biennial Conference . 2019.
Brennan TA, Hebert LE, Laird NM, et al. Hospital characteristics associated with adverse events and substandard care. JAMA . 1991;265:3265–3269.
Sousa P, Uva AS, Serranheira F, et al. Patient and hospital characteristics that influence incidence of adverse events in acute public hospitals in Portugal: a retrospective cohort study. Int J Qual Health Care . 2018;30:132–137.
Bowen S. Language barriers in access to health care. Health Canada. 2001. Available at: https://www.canada.ca/content/dam/hc-sc/migration/hc-sc/hcs-sss/alt_formats/hpb-dgps/pdf/pubs/2001-lang-acces/2001-lang-acces-eng.pdf . Accessed June 1, 2019.