Stock shot of doc with clipboard and patient
Hospitals conduct what is known as "discharge planning" to ensure that patients, once released from the hospital, continue to receive the care they need to stay healthy and avoid readmission. (Photo: iStock)

The language of health, disease and wellness – which comes with its own vocabulary–can seem like a foreign language to many patients.

However, for those with limited English proficiency who are admitted to anglophone hospitals, the barriers to understanding may be so great that health outcomes may be affected.

This was the key finding of a study published in The Journal of the American Medical Association.

A team of UHN researchers led by Drs. ShailRawal, a UHN internist, and Angela Cheung, Senior Scientist at the Toronto General Hospital Research Institute, found that patients admitted for heart failure and chronic obstructive pulmonary disease (COPD) with limited English proficiency were more likely to be readmitted to the Emergency Department (ED) than those who were proficient in English.

Specifically, about 22 per cent of those with limited English proficiency were readmitted to the ED within 30 days of discharge, while only 15 per cent of those who were proficient in English were readmitted.

The study included more than 9000 patients who were admitted for chronic conditions at the Toronto General Hospital or the Toronto Western Hospital.

While previous findings have found that English proficiency does not affect hospital readmission rates for patients admitted for hip fracture, pneumonia or acute heart attack, the current study reveals that this may not be the case for all diseases.

"The demands on patients with chronic heart failure and COPD are high," says Dr. Cheung. "Upon discharge, they are required to follow detailed instructions, manage medication regimens and oversee transitions in their care between different providers.

"Chronic heart failure and COPD may be more communication sensitive than other conditions that have simpler treatment plans."

While preliminary, these findings suggest that certain health conditions may require more rigorous communication strategies and support after discharge to ensure equal access to care.

This work was supported by the HoPingKong Centre for Excellence in Education and Practice, and the Toronto General & Western Hospital Foundation. Dr. Cheung is the Betty and KY Ho Chair in Integrative Medicine and a Tier 1 Canada Research Chair in Musculoskeletal and Postmenopausal Health.

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