Language matters: Variation in surgical readmissions across non-English language subgroups and hospitals

BACKGROUND: Patients with Limited English Proficiency (LEP) face poorer surgical outcomes, yet language-access capacity varies by hospital. OBJECTIVE: Compare 7-day readmission after common surgeries among adult patients with LEP at Language Serving Hospitals (LSH) and non-LSH, stratified by Spanish, Common Non-English, Non-Spanish (NENS) and Rare NENS Languages using the New Jersey State Inpatient Database. RESULTS: 34,342 adult surgical patients were discharged from LSH with 2.5% readmitted compared to 5.0% of those from non-LSH. Patients from LSH who spoke Spanish, (aOR 0.46, 95% CI 0.40-0.54), Common NENS (aOR 0.49, 95% CI 0.31-0.79), and Rare NENS Languages (aOR 0.50, 95% CI 0.40-0.63) had reduced odds of readmission compared to those from non-LSH. CONCLUSIONS: Surgical patients with LEP discharged from LSH had lower odds of readmission, suggesting LSH may be better equipped than non-LSH. Worse disparities for Common and Rare NENS Languages suggest the need to expand resources beyond Spanish.