The Association of Language Barriers with Gaps and Variations in the Delivery of Outpatient Care in Hispanic Persons with Epilepsy
Abstract number :
1.39
Submission category :
13. Health Services (Delivery of Care, Access to Care, Health Care Models)
Year :
2022
Submission ID :
2204215
Source :
www.aesnet.org
Presentation date :
12/3/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:23 AM
Authors :
Rafael Perez Rodriguez, MD – Mayo Clinic Health System; Raymond Faught, MD – Professor, Epilepsy, Emory School of Medicine; ioannis Karakis, MD/PhD – Professor, Epilepsy, Emory School of Medicine
This abstract has been invited to present during the Broadening Representation Inclusion and Diversity by Growing Equity (BRIDGE) poster session
Rationale: Little is known about the effect of language barriers on adhering to standardized epilepsy quality measures (EQM) in the clinic. We evaluated the association of limited english proficiency (LEP) with the quality of outpatient epilepsy care delivery.
Methods: This was a retrospective review of notes from 81 persons with epilepsy (PWE) visiting the Emory University Clinic from 2019 to 2021. Demographic and disease-related data were collected. PWE were dichotomized into English proficient (EP) and those with LEP. A comparison of EQM between the two groups was performed using Fisher’s exact test for categorical variables and the Student t-test for continuous variables.
Results: A total of 81 adult PWE (51% female, mean age 43 years) were evaluated. 51% identified as Hispanics and 26% listed Spanish as their primary language. In the encounters with Hispanic PWE, a formal interpreter was used in 10% of the cases, a family member served as an interpreter in 4% of the cases and a Spanish-speaking physician was deployed in 23% of them. For the remainder, the patients provided the history themselves in English or no documentation of the encounter language was performed. Compared to EP PWE, LEP PWE did not differ in their other demographic (age, sex) or disease-related (drug resistance) characteristics and received counseling on antiseizure medications (ASMs), sudden unexpected death in epilepsy (SUDEP), bone and reproductive health at the same degree. Yet, LEP PWE demonstrated statistically significant less counseling on safety (p=0.008) and a trend for less screening for depression (p=0.06).
Conclusions: Our study identified gaps in practice patterns in Hispanic PWE with LEP, such as counseling on safety and screening for depression. These findings call for increased awareness of the effect of language barriers in the clinic and for quality improvement of outpatient epilepsy care delivery in PWE with LEP.
Funding: None
Health Services (Delivery of Care, Access to Care, Health Care Models)