LEP inpatients with no interpreter on admission or discharge had a higher 30-day readmission rate (24.3% vs 14.9%)

Description #

Among the 3060 patient admissions examined for readmission, 529 (17.3%) were readmission events within 30 days of discharge. The 30-day readmission rate varied by interpretation pattern: 24.3% (103/423) of patients with no interpreter at admission or discharge were readmitted, compared to 16.9% (163/963) with an interpreter at admission only, 17.6% (85/482) with an interpreter at discharge only, and 14.9% (178/1192) with an interpreter on both admission and discharge (chi-square=19.5, df=3, P<0.001). In the adjusted logistic regression (Table 5, controlling for age, gender, severity, language, and LOS), patients with an interpreter on both days had lower odds of readmission than the no-interpreter reference (odds ratio 0.67, B=−0.39, P<0.01).

"The 30-day readmission rates for four patterns of interpretation are as follows: 24.3 % (103) of the 423 patient admissions who did not have an interpreter present at admission and discharge were readmitted within 30 days, compared to 16.9 % (163/963) of patients with an interpreter at admission only, 17.6 % (85/482) of those with an interpreter at discharge only, and 14.9 % (178/1192) with an interpreter at admission and discharge day (Chi-square=19.5, df=3, P<0.001)." (Lindholm, 2012, p. 1297)

"Adjusted for age, severity, LOS, and language, patients who received interpretation at admission and/or at discharge were less likely to be readmitted with 30 days than patients who received no interpretation." (Lindholm, 2012, p. 1297)

Methods Context #

What? #ⓘ

The observable: 30-day hospital readmission (a binary event within 30 days of discharge), reported as a rate per interpretation pattern and as an adjusted odds ratio.

"We also examined patient characteristics, including interpretation, associated with patients being readmitted to the hospital within 30 days." (Lindholm, 2012, p. 1296)

How? #ⓘ

Logistic regression models predicting 30-day readmission, including patient age, gender, illness severity, language, length of hospital stay in days, and receipt of professional interpretation as independent variables; unadjusted rates compared with a chi-square test. The model fit was acceptable (Hosmer & Lemeshow chi-square=8.10, df=8, P=0.42).

"Table 5 shows the logistic regression model predicting readmission that included patient age, gender, severity of illness, language, length of hospital stay in days, and receipt of interpretation as independent variables." (Lindholm, 2012, p. 1297)

Who? #ⓘ

3060 LEP patient admissions (aged ≥18, requested an interpreter) examined for readmission at a tertiary care, university hospital, 2004–2007.

"Of the 3060 patient admissions we examined for readmission, 529 (17.3 %) were readmission events within 30 days of discharge." (Lindholm, 2012, p. 1297)

Other Notes #

Single-institution retrospective analysis; readmissions captured only within the same hospital system.

Caveats #

• No English-speaking comparison group and unmeasured informal interpretation limit causal inference in the Lindholm interpretation findings The analysis is a single-institution retrospective study with no English-speaking comparison group, so it can only contrast LEP patients by interpreter-access pattern rather than against fully language-concordant care. Critically, the data do not record how often family members or untrained staff provided informal interpretation, nor whether bilingual providers spoke directly with patients — both unmeasured factors could confound the association between recorded professional interpretation and length of stay or readmission. The authors also note socioeconomic status, mental status, and exact day-of-admission interpreter use were not captured, and the single-site setting limits generalizability.