New insights into the association between use of language other than English, medical complexity, and disparities in outcomes in the pediatric intensive care unit (PICU) may help inform targeted efforts to improve care for children with medical complexity who use a language other than English so as to reduce healthcare disparities, according to researchers at Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine. They published their study in Pediatrics. 

Lead author Mary Pilarz, MD, a critical care fellow at Ann & Robert H. Lurie Children’s Hospital of Chicago, explains that the study was prompted by an unexpected finding from a prior study she conducted at Lurie Children’s. That study was about outcomes for patients who use a language other than English, and the researchers found that there was a higher rate of technology dependence among children admitted to the general pediatric service whose families use a language other than English. For the current study—a single-site retrospective cohort study of PICU encounters from September 1, 2017, to August 31, 2022—Dr. Pilarz investigated the association between language other than English and medical complexity. The researchers performed univariable and multivariable analyses between demographic factors and medical complexity for unique patients and for all encounters, and examined clinical outcomes of initial illness severity, length of stay, and days without mechanical ventilation or organ dysfunction using a mixed effects regression model, controlling for age, sex, race and ethnicity, and insurance status. 

Key Takeaways

  • Among patients in the PICU, children whose families use a language other than English are more likely to be medically complex compared to children from families who primarily speak English. 
  • The researchers then looked at outcomes for medically complex children. There were no disparities in their outcomes of interest for the medically complex population who spoke Spanish. 
  • There were pronounced differences in outcomes for the medically complex patient population who used a language other than English or Spanish. 
  • For the next step, Dr. Pilarz would like to see a multi-center study to determine if these findings are true at other large children’s hospitals. 

Pediatric research at Ann & Robert H. Lurie Children’s is conducted through Stanley Manne Children’s Research Institute.  

Article Citation 

Pilarz M, Bleed E, Rodriguez V, et al. Medical Complexity, Language Use, and Outcomes in the Pediatric Intensive Care Unit. Pediatrics. Epub May 15, 2024. DOI: https://doi.org/10.1542/peds.2023-063359