Limited English proficiency is associated with reduced access to surgical care

Narrative synthesis #

Across the review's 6 access-to-surgical-care studies, LEP was significantly associated with reduced access to care in adjusted analysis in 4 of 6. The review notes heterogeneity: 1 of those studies found the association only among non–Spanish-speaking LEP patients, and 2 studies performed only unadjusted analyses and found no association. Because all included studies were observational with residual confounding, the review reports directionality of evidence rather than a pooled estimate; the certainty/GRADE appraisal is left for expert review.

"Six included studies assessed access to surgical care... Four of these 6 studies found LEP to be significantly associated with reduced access to care in adjusted analysis. However, 1 of these studies revealed a significant association only in patients with non–Spanish-speaking LEP. Two studies performed only unadjusted analyses and identified no association between LEP and limited access to care." (Joo, 2023, p. 7)

"Surgical patients with limited English proficiency were more likely to experience reduced access in 4 of 6 studies, delays in obtaining care in 3 of 4 studies, longer surgical admission length of stay in 6 of 14 studies, and more likely discharge to a skilled facility than patients with English proficiency in 3 of 4 studies." (Joo, 2023, p. 1)