316 - Language, Racial and Ethnic Disparities in Successful Post-Discharge Telephone Call Completion Rates

Poster Number: 316
Publication Number: 316.322

Courtney A. Gilliam, Seattle Children's, Seattle, WA, United States; Aaron McAdie, Seattle Children's Hospital, Seattle, WA, United States; Jeff Foti, Seattle Children's, Seattle, WA, United States; Anu Asnani, SCH, Seattle, WA, United States; jimmy beck, University of Washington School of Medicine, Seattle, WA, United States; Arti D. Desai, University of Washington School of Medicine, Seattle, WA, United States

Background: Post-discharge telephone calls (PDTCs) are effective for identifying and addressing issues in the first few days following hospitalization. Although PDTCs have been implemented widely, it remains unclear whether PDTCs are equitably delivered to ensure all families benefit from this hospital-to-home intervention.

Objective: To examine associations between family’s language for care and PDTC modality (automated versus live person) and successful call completion rates. Secondarily, we aimed to examine the association between racial and ethnic identity and successful PDTC completion.

Design/Methods: Retrospective cohort study of patients discharged from a tertiary children’s hospital between 03/2018 and 9/2021 in which a PDTC was attempted to identify and address questions and concerns within 24 hours after discharge. PDTCs were deemed “successful” if the recipient answered at least the first question. Over the study period, PDTCs were delivered via an automated service (pre-recorded prompts) to families who spoke English and Spanish. Families who spoke either Somali or Vietnamese initially received PDTCs via a live service (language concordant person) and switched to an automated service in 12/2018. PDTC modality did not differ based on racial or ethnic identity. Univariate logistic regression models were used to examine the association between language for care, call modality, or racial or ethnic identity, and successful PDTC rates.

Results: We included 43,138 eligible discharge encounters (English: n=39,832; Somali: n=186; Spanish: n=2,962; and Vietnamese: n=158; and 50.2% from historically marginalized racial or ethnic groups). Of these, 28 and 30 PDTCs were delivered via live service to Somali and Vietnamese families, respectively. Successful PDTCs were significantly lower among families who spoke Somali compared to families who spoke English (OR 0.46, 95% CI: 0.35, 0.60). Among families who spoke either Somali or Vietnamese, successful PDTCs were significantly higher when delivered by a live service compared to an automated service (OR: 2.32, 95% CI: 1.21, 4.46). Successful PDTCs were significantly lower among patients from historically marginalized racial or ethnic groups compared to families identifying as non-Hispanic White (Table 1).Conclusion(s):
Hospitals should consider tailoring or adapting the delivery of PDTCs to address inequities in successful PDTC completion rates. Further research is needed to examine the impact of PDTC interventions on disparities in health outcomes and healthcare utilization such as hospital readmissions.

Table 1. Odds of Successful Post-Discharge Telephone Call Completion by Race and Ethnicity