80 - Parental Limited English Proficiency and Unscheduled Healthcare Utilization among Children with Asthma in Washington, DC – A Population-based Study

Poster Number: 80
Publication Number: 80.210

Mickey Emmanuel, Children's National Health System, Washington, DC, United States; Rachel Margolis, Children's National Hospital, Washington, DC, United States; Nikita Kachroo, Children's National Health System, Washington, DC, United States; Stephen J. Teach, Children's National Hospital, Washington, DC, United States; Kavita Parikh, Children's National Health System, Washington DC, DC, United States

Background: Asthma is a leading cause of pediatric healthcare utilization and disproportionately affects children experiencing health care disadvantages. Limited English proficiency (LEP) is associated with longer emergency department (ED) stays and higher hospitalization rates in other diseases, but little is known of its effect on pediatric asthma healthcare utilization.

Objective: To evaluate whether parental LEP is associated with asthma-related unscheduled health care utilization in children. We hypothesized that parental LEP would be significantly associated with increased ED encounters and hospitalizations for asthma.

Design/Methods: This was a retrospective cohort study using population level data from the District of Columbia (DC) Pediatric Asthma Registry. This study included all children aged 2-17 years in the Asthma Registry in 2019. The primary exposure variable was parental LEP defined by self-identified parental language preference. Outcomes included ED encounters and hospitalizations for asthma in 2019. Chi-squared and t-tests were used to examine demographic differences and Poisson regression was used to determine adjusted relative risks.

Results: The Registry included 14,584 participants including 1331 (9.1%) with LEP. Spanish was the most common language reported in the LEP group (1103 patients, 82.9% of those with LEP). Compared to the parental EP group, those with parental LEP were significantly more likely to be Hispanic (79.8%), self-pay/other insurance (15.1%) and without persistent asthma diagnosis (78.0%).  In analyses adjusted for age, sex, race/ethnicity, insurance status, and diagnosis of persistent asthma, parental LEP was associated with higher risk of ED encounters [adjRR 1.20 (95% CI, 1.00-1.45)] and hospitalizations [adjRR 1.73 (95% CI, 1.21-2.47)]. In the subset of Hispanic patients, LEP was also associated with a higher risk of ED encounters [adRR 1.38 (95% CI, 1.08-1.75)] and hospitalizations [adjRR 1.90 (95% CI, 1.18-3.07)].Conclusion(s): Among DC children with asthma, parental LEP was associated with increased unscheduled healthcare utilization. Focus on understanding barriers for parents with LEP and developing inventions to alleviate them may reduce pediatric asthma-related unscheduled health care utilization.
Table 1: Demographics of Study Population
Table 2: Association between Demographic Characteristics and Healthcare Utilization