Language and length of stay in the pediatric emergency department

Background: Quality and accessibility of care for patients presenting to the emergency department (ED) can be limited if they cannot communicate in the same language as their health care provider. Study Objectives: We aimed to determine if children whose parents speak a primary language other than English have a longer length of stay (LOS) in the ED compared with English-speaking families. Methods: We reviewed computerized ED records of age-matched English and 4 most common non-English languages in a tertiary pediatric hospital in Toronto, Canada. We randomly chose English-speaking families in a 3:1 ratio with non-English. We performed bivariate analyses and a multivariable linear regression to test the relationship between language, triage score, age, gender, day of the week, and diagnostic grouping. Results: Out of 48,497 visits for 1 year, we included 6051 English-, 628 Spanish-, 486 Cantonese-, 486 Mandarin-, and 417 Tamil-speaking families. The average LOS was 3.86 and 3.95 hours for English and non-English-speaking patients, respectively (P > 0.05). Non-English speakers had lower acuity more frequently (P = 0.004) and arrived more over weekdays (P = 0.02). In the multivariate regression model, language, triage score, age, and gender were all significantly associated with LOS. Only 6% of the variance in LOS was explained by the regression model. Conclusions: Language, triage score, patient age, and gender are significantly associated with LOS in the ED. Among other interventions, securing ways to accommodate non-English-speaking health providers in the ED can possibly shorten the LOS and reduce nonacute visits to the ED.