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

Gabriela D Ruiz Colón; Rebecca J Pizzitola; Gerald A Grant; Laura M Prolo

doi:10.1016/j.jpeds.2023.113678

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

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

Authors

Gabriela D Ruiz Colón¹, Rebecca J Pizzitola¹, Gerald A Grant², Laura M Prolo³

Affiliations

¹ Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA.
² Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA; Department of Neurosurgery, Duke University School of Medicine, Durham, NC.
³ Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA; Division of Pediatric Neurosurgery, Lucile Packard Children's Hospital, Palo Alto, CA. Electronic address: lmprolo@stanford.edu.

PMID: 37611737
DOI: 10.1016/j.jpeds.2023.113678

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.

MeSH terms

Adolescent
Child
Communication*
Humans
Hydrocephalus* / etiology
Hydrocephalus* / surgery
Language
Postoperative Complications / etiology
Retrospective Studies
Ventriculoperitoneal Shunt / methods
Ventriculostomy / methods