Pediatric Patients Whose Caregivers Preferred a Non-english Language Less Likely to Be Triaged Appropriately in Emergency Departments: Study

Pediatric patients arriving at a hospital emergency department with caregivers who prefer languages other than English are more likely to be “under-triaged” -- or categorized as needing less urgent medical attention than English-speaking patients would be under the same circumstances, according to a study published in the June 2023 Pediatrics. Triage, as the initial assessment to determine sorting of patients by acuity and severity—is a critical first step in the emergency department encounter. The study, “Under-triage for Children with Caregivers Preferring Languages Other than English,” published online May 16, analyzed emergency department visits for patients under age 21 from January 1, 2019 to January 31, 2021 at two Washington, D.C. medical facilities – one a large academic urban children’s hospital and the other a satellite urban free-standing pediatric emergency department. Nearly 20% (22,525) of 114,266 total emergency department visits represented patients with caregivers preferring languages other than English. These children were more likely to experience under-triage compared to those with caregivers preferring English (3.7% (English) versus 4.6% (Spanish) versus 5.9% (other languages). Specifically, children with caregivers who prefer languages other than English are more likely to be assigned a triage acuity that did not align with the care they would ultimately need, such as hospital admission, significant emergency department resource use (nebulized medication, IV placement, or supplemental oxygen), or a return to the emergency department with admission within 14 days. The authors recommend interventions to understand and reduce inequity in the triage process.

###

The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.