Interpreter need (language discordance) is associated with discharge to a rehabilitation facility rather than home

Narrative synthesis #

This is an exposure-contrast claim: patients who require an interpreter (a marker of language discordance) are more likely to be discharged to a subacute or acute rehabilitation facility rather than home. In a matched single-institution total shoulder arthroplasty (TSA) cohort, interpreter need was the strongest multivariate predictor of discharge disposition — interpreter-requiring patients were 454% more likely (OR 4.54, 95% CI 2.13–8.61, P = .037) to go to a rehabilitation facility, with a consistent bivariate gradient (19.5% vs 4.9%, P = .033) (Kunze/Kyle 2023). The authors speculate the mechanism is communication-barrier-driven: discordant patients may be less able to express readiness for discharge or confidence in postoperative function. As a single-site retrospective cohort it cannot establish causation, and interpreter need may proxy unmeasured clinical or social complexity; the certainty/GRADE appraisal is left for expert review.

"Multivariate logistic regression demonstrated that the need for an interpreter was the strongest predictor of discharge disposition, with patients who required an interpreter being 454% more likely to be discharged to a subacute or acute rehabilitation facility compared with patients who did not need an interpreter (Table 3)." (Kunze, 2023, p. 88)

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