Effect of Language Barriers on Follow-up Appointments After an Emergency Department Visit


Address correspondence and reprint requests to Dr. Baker: MetroHealth Medical Center, 2500 MetroHealth Dr., Rammelkamp 221, Cleveland, OH 44109-1998 (E-mail: dwb@po.cwru.edu).


OBJECTIVE: To determine whether patients who encountered language barriers during an emergency department visit were less likely to be referred for a follow-up appointment and less likely to complete a recommended appointment.

DESIGN: Cohort study.

SETTING: Public hospital emergency department.

PARTICIPANTS: English- and Spanish-speaking patients (N = 714) presenting with nonemergent medical problems.

MEASUREMENTS AND MAIN RESULTS: Patients were interviewed to determine sociodemographic information, health status, whether an interpreter was used, and whether an interpreter should have been used. The dependent variables were referral for a follow-up appointment after the emergency department visit and appointment compliance, as determined by chart review and the hospital information system. The proportion of patients who received a follow-up appointment was 83% for those without language barriers, 75% for those who communicated through an interpreter, and 76% for those who said an interpreter should have been used but was not (P = .05). In multivariate analysis, the adjusted odds ratio for not receiving a follow-up appointment was 1.92 (95% confidence interval [CI], 1.11 to 3.33) for patients who had an interpreter and 1.79 (95% CI, 1.00 to 3.23) for patients who said an interpreter should have been used (compared with patients without language barriers). Appointment compliance rates were similar for patients who communicated through an interpreter, those who said an interpreter should have been used but was not, and those without language barriers (60%, 54%, and 64%, respectively; P = .78).

CONCLUSIONS: Language barriers may decrease the likelihood that a patient is given a follow-up appointment after an emergency department visit. However, patients who experienced language barriers were equally likely to comply with follow-up appointments.