Disparities in Postoperative Communication Patterns Among Spanish-speaking Pediatric Patients with Hydrocephalus

• Published in: The Journal of pediatrics Vol. 263; p. 113678
• Main Authors: Ruiz Colón, Gabriela D., Pizzitola, Rebecca J., Grant, Gerald A., Prolo, Laura M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-12-2023
• Subjects: Adolescent; Child; Communication; healthcare disparities; healthcare utilization; Humans; Hydrocephalus - etiology; Hydrocephalus - surgery; Language; language discordance; neurosurgery; pediatric hydrocephalus; Postoperative Complications - etiology; quality; Retrospective Studies; Ventriculoperitoneal Shunt - methods; Ventriculostomy - methods; ESP; healthcare disparities; EMR; language discordance; quality; LOS; SSP; healthcare utilization; pediatric hydrocephalus; IVH; communication; neurosurgery; ED
• DOI: 10.1016/j.jpeds.2023.113678
• EISSN: 1097-6833
• ISSN: 0022-3476; 1097-6833

To determine if differences exist in postoperative communication patterns or healthcare use among English-speaking patients (ESPs) and Spanish-speaking patients (SSPs) with childhood hydrocephalus.
A single-institution, retrospective cohort study was conducted. Through simple random sampling, 50 ESPs and 50 SSPs (<18 years old) who underwent a ventriculoperitoneal shunt or endoscopic third ventriculostomy were identified. Demographics, communication with clinic (eg, number of calls or messages postoperatively), and healthcare use were collected. Multiple linear regressions assessed the significance of predictors on communication frequency and use.
SSPs were more likely to have a comorbidity and ventriculoperitoneal shunt than ESPs. SSPs had longer median postoperative length of stay (P < .01) and 30-day readmission rate (P < .01) than ESPs. Only 18% of SSPs communicated with clinic; 11 total calls or messages were from SSPs vs 57 from ESPs (P < .01). The most common reason for outreach among both cohorts was a new symptom. ESP outreach most frequently resulted in reassurance or medical course changes on an outpatient basis (30% ESPs vs 0% SSPs; P = .04), whereas SSP outreach most frequently resulted in guidance to present to the emergency department (3% ESPs vs 36% SSPs; P < .01). Language remained a significant predictor for number of calls or messages, even after adjusting for comorbidity, operation type, and insurance (P < .01).
Despite having more complex disease, only 18% of SSPs communicated with the neurosurgical team postoperatively and were more frequently sent to the emergency department for management. Future research will explore communication barriers and preferences to ensure postoperative care is timely and patient centered.