IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0279126.html
   My bibliography  Save this article

Comparative costs for critically ill patients with limited English proficiency versus English proficiency

Author

Listed:
  • Amelia K Barwise
  • James P Moriarty
  • Jordan K Rosedahl
  • Jalal Soleimani
  • Alberto Marquez
  • Timothy J Weister
  • Ognjen Gajic
  • Bijan J Borah

Abstract

Objectives: To conduct comparative cost analysis of hospital care for critically ill patients with Limited English Proficiency (LEP) versus patients with English proficiency (controls). Patients and methods: We conducted a historical cohort study using propensity matching at Mayo Clinic Rochester, a quaternary care academic center. We included hospitalized patients who had at least one admission to ICU during a 10-year period between 1/1/2008-12/31/2017. Results: Due to substantial differences in baseline characteristics of the groups, propensity matching for the covariates age, sex, race, ethnicity, APACHE 3 score, and Charlson Comorbidity score was used, and we achieved the intended balance. The final cohort included 80,404 patients, 4,246 with LEP and 76,158 controls. Patients with LEP had higher costs during hospital admission to discharge, with a mean cost difference of $3861 (95% CI $822 to $6900, p = 0.013) and also higher costs during index ICU admission to hospital discharge, with a mean cost difference of $3166 (95% CI $231 to $6101, p = 0.035). A propensity matched cohort including only those that survived showed those with LEP had significantly greater mean costs for all outcomes. Sensitivity analysis revealed that international patients with LEP had significantly greater overall hospital costs of $9,240 than patients with LEP who resided in the US (95% CI $3341 to $15,140, p = 0.002). Conclusion: This is the first study to demonstrate significantly higher costs for patients with LEP experiencing a critical illness. The causes for this may be increased healthcare utilization secondary to communication deficiencies that impede timely decision making about care.

Suggested Citation

  • Amelia K Barwise & James P Moriarty & Jordan K Rosedahl & Jalal Soleimani & Alberto Marquez & Timothy J Weister & Ognjen Gajic & Bijan J Borah, 2023. "Comparative costs for critically ill patients with limited English proficiency versus English proficiency," PLOS ONE, Public Library of Science, vol. 18(4), pages 1-13, April.
    • Handle: RePEc:plo:pone00:0279126
    DOI: 10.1371/journal.pone.0279126
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0279126
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0279126&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0279126?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Manning, Willard G. & Basu, Anirban & Mullahy, John, 2005. "Generalized modeling approaches to risk adjustment of skewed outcomes data," Journal of Health Economics, Elsevier, vol. 24(3), pages 465-488, May.
    2. repec:plo:pmed00:0040296 is not listed on IDEAS
    3. Jacobs, E.A. & Shepard, D.S. & Suaya, J.A. & Stone, E.-L., 2004. "Overcoming Language Barriers in Health Care: Costs and Benefits of Interpreter Services," American Journal of Public Health, American Public Health Association, vol. 94(5), pages 866-869.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Sankar Mukhopadhyay & Wei Yang & Wai Lee & Jeanne Wendel, 2008. "Analyzing the impact of prenatal care on infant health: do we have useful input and output measures?," Economics Bulletin, AccessEcon, vol. 9(22), pages 1-14.
    2. Stephen Mac & Gerald Evans & Eleanor Pullenayegum & Samir N Patel & Beate Sander, 2023. "Healthcare costs and outcomes associated with laboratory-confirmed Lyme disease in Ontario, Canada: A population-based cohort study," PLOS ONE, Public Library of Science, vol. 18(6), pages 1-16, June.
    3. Courbage, Christophe & Rey, Béatrice, 2012. "Priority setting in health care and higher order degree change in risk," Journal of Health Economics, Elsevier, vol. 31(3), pages 484-489.
    4. Alice W. Migongo & Richard Charnigo & Margaret M. Love & Richard Kryscio & Steven T. Fleming & Kevin A. Pearce, 2012. "Factors Relating to Patient Visit Time With a Physician," Medical Decision Making, , vol. 32(1), pages 93-104, January.
    5. Jones, A.M, 2010. "Models For Health Care," Health, Econometrics and Data Group (HEDG) Working Papers 10/01, HEDG, c/o Department of Economics, University of York.
    6. Caballer-Tarazona, Vicent & Guadalajara-Olmeda, Natividad & Vivas-Consuelo, David, 2019. "Predicting healthcare expenditure by multimorbidity groups," Health Policy, Elsevier, vol. 123(4), pages 427-434.
    7. Onur Başer & Joseph C. Gardiner & Cathy J. Bradley & Hüseyin Yüce & Charles Given, 2006. "Longitudinal analysis of censored medical cost data," Health Economics, John Wiley & Sons, Ltd., vol. 15(5), pages 513-525, May.
    8. Toni Mora & Joan Gil & Antoni Sicras-Mainar, 2012. "The Influence of BMI, Obesity and Overweight on Medical Costs: A Panel Data Approach," Working Papers 2012-08, FEDEA.
    9. Liu, Lei & Strawderman, Robert L. & Cowen, Mark E. & Shih, Ya-Chen T., 2010. "A flexible two-part random effects model for correlated medical costs," Journal of Health Economics, Elsevier, vol. 29(1), pages 110-123, January.
    10. Jean‐Paul Chaze, 2005. "Assessing household health expenditure with Box–Cox censoring models," Health Economics, John Wiley & Sons, Ltd., vol. 14(9), pages 893-907, September.
    11. Keane, Michael & Stavrunova, Olena, 2016. "Adverse selection, moral hazard and the demand for Medigap insurance," Journal of Econometrics, Elsevier, vol. 190(1), pages 62-78.
    12. Laurent Carnis & Hamza Achit, 2014. "The injured victim's health care spending: is there an effect of the origin of accident?," Applied Economics Letters, Taylor & Francis Journals, vol. 21(5), pages 350-355, March.
    13. Tor Iversen & Eline Aas & Gunnar Rosenqvist & Unto Häkkinen & on behalf of the EuroHOPE study group, 2015. "Comparative Analysis of Treatment Costs in EUROHOPE," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 5-22, December.
    14. Toni Mora & Joan Gil & Antoni Sicras-Mainar, 2015. "The influence of obesity and overweight on medical costs: a panel data perspective," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(2), pages 161-173, March.
    15. Marcel Bilger & Willard G. Manning, 2015. "Measuring Overfitting In Nonlinear Models: A New Method And An Application To Health Expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 24(1), pages 75-85, January.
    16. Manning, Willard G. & Basu, Anirban & Mullahy, John, 2005. "Generalized modeling approaches to risk adjustment of skewed outcomes data," Journal of Health Economics, Elsevier, vol. 24(3), pages 465-488, May.
    17. Dunn, Abe, 2016. "Health insurance and the demand for medical care: Instrumental variable estimates using health insurer claims data," Journal of Health Economics, Elsevier, vol. 48(C), pages 74-88.
    18. Kaushik Ghosh & Irina Bondarenko & Kassandra L Messer & Susan T Stewart & Trivellore Raghunathan & Allison B Rosen & David M Cutler, 2020. "Attributing medical spending to conditions: A comparison of methods," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-17, August.
    19. Kurt Lavetti & Thomas DeLeire & Nicolas R. Ziebarth, 2023. "How do low‐income enrollees in the Affordable Care Act marketplaces respond to cost‐sharing?," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 90(1), pages 155-183, March.
    20. Amir Marashi & Shima Ghassem Pour & Vincy Li & Chris Rissel & Federico Girosi, 2019. "The association between physical activity and hospital payments for acute admissions in the Australian population aged 45 and over," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-16, June.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0279126. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.