Objective. Language barriers may lead to medical errors by impeding patient-provider communication. The objective of this study was to determine whether hospitalized pediatric patients whose families have language barriers are more likely to incur serious medical errors than patients whose families do not have language barriers.
Methods. A case-control study was conducted in a large, academic, regional children's hospital in the Pacific Northwest. Case patients (n = 97) included all hospitalizations of patients who were younger than 21 years and had a reported serious medical event from January 1, 1998, to December 31, 2003. Control patients (n = 475) were chosen from hospitalizations without a reported serious medical event and were matched with case patients on age, admitting service, admission to intensive care, and date of admission. The main exposure was a language barrier defined by self- or provider-reported need for an interpreter. Serious medical events were defined as events that led to unintended or potentially adverse outcomes identified by the hospital's quality improvement staff.
Results. Fourteen (14.4%) of the case patients and 53 (11.2%) of the control patients were assigned an interpreter during their hospitalization. Overall, we found no increased risk for serious medical events in patients and families who requested an interpreter compared with patients and families who did not request an interpreter (odds ratio: 1.36; 95% confidence interval: 0.73–2.55). Spanish-speaking patients who requested an interpreter comprised 11 (11.3%) of the case patients and 26 (5.5%) of the control patients. This subgroup had a twofold increased risk for serious medical events compared with patients who did not request an interpreter (odds ratio: 2.26; 95% confidence interval: 1.06–4.81).
Conclusions. Spanish-speaking patients whose families have a language barrier seem to have a significantly increased risk for serious medical events during pediatric hospitalization compared with patients whose families do not have a language barrier.
Comments
Potentially serious errors due to language barrier
Editor,
We read with interest the paper by Cohen et al, on language barriers leading to medical errors, published in the September issue of Pediatrics
We would like to add our experience on this issue. In the last decade following the influx of economic refugees to Greece, we had 5 neonates admitted to the Neonatal Unit for variable reasons to whom wrong dosing or wrong medication had been administered by the mother to these neonates. These were identified during history taking. These neonates had been disharged from various maternity hospitals in Athens. In all instances the mother was an economic refugee with poor inderstanding of the Greek language. The medications involved were as follows: Paracetamol (wrong dosing)(1 case), Ferrum solution (Ferric hydroxide polymaltose)prescribed by two different Obstetricians to the mothers and wrongly administered to the babies (2 cases) and 2 more cases, where the corresponding neonates had received methylergometrine maleate prescribed by two different Obstetricians to the mothers and wrongly administered to the babies. In all instances the neonates did not require special measures and were discharged in good condition.
The cases described may only be the tip of the iceberg and simply highlight a newly emerging problem as Greek society is rapidly becoming multilingual and multicultural
Conflict of Interest:
None declared