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. 2023 Dec:263:113678.
doi: 10.1016/j.jpeds.2023.113678. Epub 2023 Aug 21.

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

Gabriela D Ruiz Colón  1 , Rebecca J Pizzitola  1 , Gerald A Grant  2 , Laura M Prolo  3
Affiliations

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

Gabriela D Ruiz Colón et al. J Pediatr. 2023 Dec.

Abstract

Objective: 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.

Study design: 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.

Results: 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).

Conclusions: 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.

Keywords: communication; healthcare disparities; healthcare utilization; language discordance; neurosurgery; pediatric hydrocephalus; quality.

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Conflict of interest statement

Declaration of Competing Interest This publication was generously supported by the Stanford Maternal and Child Health Research Institute Structural Racism, Social Injustice and Health Disparities Program (to L.M.P.) as well as the Stanford University Medical Scholars Program (to G.R.C.). The authors have no conflicts of interest to disclose.

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