NON-ENGLISH LANGUAGE PROFICIENCY AND ENGAGEMENT WITH OUTPATIENT SPECIALTY MEDICAL CARE FOLLOWING ICU ADMISSION FOR COVID-19: A RETROSPECTIVE COHORT STUDY

ABSTRACT

SESSION TITLE Post-COVID-19 Outcomes SESSION TYPE Rapid Fire Original Inv PRESENTED ON 10/19/2022 1115 am - 1215 pm PURPOSE: Minority populations, including non-English language proficient individuals, experience a disproportionate burden of morbidity and mortality from COVID-19.1,2 While these same populations have historically experienced disparities in critical illness, less is known about disparities in post-acute care following critical illness3. Here, we investigate if non-English language proficiency is associated with differential access to dedicated post-COVID-19-clinic care among intensive care unit (ICU) survivors. METHODS: We retrospectively collected demographic (self-identified), clinical, and utilization data from electronic health records for all patients with COVID-19 admitted to an ICU at three Mass General Brigham hospitals between March 11-May 31, 2020. We performed multivariable logistic regression, adjusting for age, gender, race and ethnicity, insurance status, area deprivation index (a marker of geographic socioeconomic deprivation), medical comorbidities, and discharge destination, to examine if non-English language proficiency, defined as “Needs Interpreter” in the medical record, was associated with access to outpatient post-COVID care (composite of dedicated post-ICU pulmonary, neurology, or physical medicine and rehabilitation clinic visit). RESULTS: Of 481 patients in our cohort, 61% (n=292) survived to one month after hospital discharge. The majority (71.2%) were discharged to a facility. Within 12 months after discharge, most patients had at least one primary care visit (84.7%), but far fewer were seen in a dedicated post-COVID clinic (27.1%). In multivariable analyses, non-English language proficiency was associated with no difference in primary care follow up (adjusted OR = 0.83, 95% CI 0.30-2.25, p=0.71), but was associated with decreased odds of a dedicated post-COVID clinic visit (aOR = 0.73, 95% CI 0.61-0.87, p < 0.001). CONCLUSIONS: Although we identified no difference in access to primary care, non-English language proficiency was associated with decreased odds of visiting a dedicated post-COVID clinic. Further research is needed to understand the system, provider, and patient factors contributing to these disparities and how to decrease barriers to subspecialty care among non-English language proficient ICU survivors. CLINICAL IMPLICATIONS As the number of COVID-19 critical illness survivors increase, it will become increasingly important to not only develop multi-disciplinary interventions to support their recovery, but also ensure equity in access to these services. In our cohort of ICU survivors, we identified no difference in access to primary care according to preferred language language, but decreased odds of access to post-COVID clinics among survivors with non English language proficiency, pointing towards a need for further research to understand and mitigate these disparities. DISCLOSURES No relevant relationships by George Alba No relevant relationships by Lisa Bebell No relevant relationships by Leslie Chang No relevant relationships by Nupur Dandawate No relevant relationships by Alexander Gavralidis No relevant relationships by Patrick Gordan no disclosure on file for Kathryn Hibbert;No relevant relationships by Cher Huang No relevant relationships by Sirus Jesudasen no disclosure on file for Aran Kadar;no disclosure on file for Peggy Lai;No relevant relationships by Emily Moin No relevant relationships by Daniel Okin Consultant relationship with United Therapeutics Please note 1 day Added 04/03/2022 by Alison Witkin, value=Consulting fee