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Disparities in Postoperative Communication Patterns Among Spanish-speaking Pediatric Patients with Hydrocephalus - 23/11/23

Doi : 10.1016/j.jpeds.2023.113678 
Gabriela D. Ruiz Colón, BA 1, Rebecca J. Pizzitola 1, Gerald A. Grant, MD, FACS 1, 2, Laura M. Prolo, MD, PhD 1, 3,
1 Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA 
2 Department of Neurosurgery, Duke University School of Medicine, Durham, NC 
3 Division of Pediatric Neurosurgery, Lucile Packard Children's Hospital, Palo Alto, CA 

Reprint requests: Laura M. Prolo, MD, PhD, Division of Pediatric Neurosurgery, Department of Neurosurgery, 1201 Welch Rd, MSLS (P306), Stanford, CA 94305.Division of Pediatric NeurosurgeryDepartment of Neurosurgery1201 Welch RdMSLS (P306)StanfordCA94305

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.

Le texte complet de cet article est disponible en PDF.

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

Abbreviations : ED, EMR, ESP, IVH, LOS, SSP


Plan


 A portion of the findings presented in this manuscript were presented at the American Association of Neurological Surgeons/Congress of Neurological Surgeons' Joint Section on Pediatric Neurological Surgery Annual Meeting in Washington, DC, December 2022, and the San Francisco Neurological Society's Annual Meeting in Napa Valley, California (March 2023).


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Vol 263

Article 113678- décembre 2023 Retour au numéro
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