When patients face language barriers, having the same home health nurse across the care timeline significantly decreases hospital readmissions.
That’s according to a new study from New York University’s Rory Meyers College of Nursing.
“If you have a nurse who can consistently work with the same patient and their family members — and utilize interpreter services — you could have the same effects as if you have a nurse who speaks the same language as the patient,” Allison Squires, a professor at NYU, told Home Health Care News.
One of the challenges of home health care, Squires noted, is that there is often a reliance on per diem nurses. In that case, different nurses come in and out of a patient’s home and the lack of a personalized care program can have an ill effect on those patients.
Having a full-time nurse who is consistently in the home pays off in the long run.
In this study, Squires and her colleagues collected and looked through data from over 22,000 patients who were receiving home health care in New York City following a hospitalization. The patients spoke Spanish, Korean, Chinese or Russian as their primary language.
Of the 22,103 patients, 20.4% were re-hospitalized while 79.6% ended their home health period without a rehospitalization.
Of those patients:
– 47% had low continuity of care and language concordance
– 39% had high continuity of care and low language concordance
– 11% had high continuity of care and language concordance
– 3% had low continuity of care and high language concordance.
“Our model showed that in all instances where continuity of care was high, there was a significantly decreased rate of readmission,” the study’s authors wrote. “In addition, when continuity of care was low despite high language concordance, there was not a significant relationship. From this, we conclude that — regarding hospital readmission from home health care — continuity of care is of greater importance than language concordance for home health visits.”
Research from NYU also found that home health care patients who speak a language other than English are at a higher risk for readmission to the hospital.
One of the major takeaways from the study for Squires is that it is in the best financial interest for providers to pay closer attention to non-English speaking patients because of the potential value-based benefits that come with it.
“This is a growing sector of the population — especially the Medicare-insured population — and there’s going to be an increased demand for these types of language-concorded services,” Squires said. “With aging, one thing that we know is even if you have learned to speak English, if you have cognitive changes of any kind, you are probably going to lose your language skills first and go back to your first language.”
At first, Squires was surprised that continuity of care and language concordance could be equally effective in home health care.
However, after digging through the data, it made more sense.
“Because the more often you work with a patient, the better you get to know them,” Squires said. “The more you work with them, the more easily you are able to anticipate their needs, understand how they operate and how they make decisions.”
