Protecting the Rights of Limited English Proficiency Patients During Hospital Discharge

Abstract

Discharge instructions were originally created to alleviate the burden of transitioning from inpatient hospitalization to outpatient care. The US healthcare model's evolution throughout the 20th and 21st centuries has firmly distinguished inpatient providers from outpatient providers, with little continuity between them. As a patient leaves inpatient care there is an increasing need for clear discharge instructions to help navigate complex diseases and care regimens. However, comprehension of discharge instructions, both oral and written, is a major obstacle for many populations, with certain demographics especially affected. Populations with limited English proficiency (LEP), for example, are commonly provided discharge instructions in English, preventing them from fully engaging in their care and from understanding information that is paramount to a smooth transition to outpatient settings. Many factors contribute to the failure to provide this and other care in LEP patients' primary languages. Factors include but are not limited to: misinformation regarding price of interpreter services and time necessary to use these services, biases against LEP populations, and ignorance regarding the effect this has on the LEP population. This paper discusses the background of discharge instructions, reasons for development, the price LEP patients pay when we fail to provide care in their primary language, and possible reasons why we fail to provide that care.