Patient health disparity barriers at hospital discharge

July 22, 2021

A new study by research, quality improvement and health equity experts at Massachusetts General Hospital (MGH) lays out the challenges of achieving equity for diverse patients in communication at hospital discharge.

The study was published in the American Journal of Managed Care.

A survey of 224 recently discharged patients was conducted in five languages just before the COVID-19 pandemic and highlighted challenges, including limited understanding of medications; lack of available professional medical interpreters and translated patient instructions at discharge; and worries about support for at home after hospitalization.

Major findings include:

·        Overall, one in four patients were alone at discharge, without a family member or friend to accompany them, a factor that may contribute to miscommunication.

·         More than half of patients with limited English proficiency reported lack of access to medical interpreters and translated materials at the time of discharge

·         Significant differences were reported in technology access to smartphones, laptop or tablet computers, and to the electronic health record patient portal by patients who are Hispanic, Latino, Black or African American, and experience limited English proficiency. Only 25% of Hispanic or Latino patients and 57% of Black patients reported having laptop or tablet computers, and fewer than 10% of Hispanic or Latino patients had used the patient portal.

·         Patients of Asian or Pacific Islander descent were more likely to express worries about understanding medications and about getting home health services.

Esteban Barreto, PhD, lead author of the paper, says the researchers conducted the study to gather a more rich and nuanced view of patient perspectives than can be found in standard quality improvement surveys. “We employed a team approach to survey development and translation, embedding in the team bilingual interviewers and clinicians from diverse backgrounds to capture the experience of this patient population,” he says. “This was a work of love for the team.”

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