Pilot study of provider adherence to language services for surgical patients with limited English proficiency

Background: Section 1557 of the Affordable Care Act mandates the use of professional medical language services for patients with limited English proficiency (LEP). Policy adherence rates and associated surgical outcomes are unknown. Methods: A retrospective pilot study of 230 LEP patients ≥18 years undergoing cholecystectomy (January 2021-January 2024) was conducted at a single academic institution. The frequency of interpreter service use and language concordant documentation were abstracted from the electronic health record. Regression analysis was used to examine the association between section 1557 compliance and length of stay (LOS), emergency department (ED) re-visit, hospital readmission, and surgeon follow-up. Results: Interpreter use was documented for 62.2 ​% of patients and 30 ​% received language concordant documentation. Interpreter service utilization and language concordant documentation were not significantly associated with LOS, ED visits, hospital readmissions, or surgeon follow-up. Conclusions: Language interpreter services are underutilized for LEP patients. These findings suggest the need for further investigation into the barriers to providing this service for patients during a time of critical decision-making.