Inequities in Hip Fracture Care: Non-English-Speaking Older Patients Face Higher Risks

A new study conducted at Women’s Age Lab at Women’s College Hospital (WCH) suggests inequities in hip fracture care for non-English-speaking patients in English-dominant healthcare settings.

While language-related disparities for elective surgeries have been well documented, little is known about outcomes for non-English speakers with hip fracture, an emergent, common and costly event associated with significant morbidity and mortality in older adults. Due to rising global migration and demographic aging, serving older patients from linguistically diverse backgrounds will be an increasing reality for healthcare jurisdictions across many Western countries.

Key Findings:

  • This study followed 35,238 older adults who underwent hip fracture surgery and found that non-English-speaking patients were more likely to get delirium and myocardial infarction (heart attack), have longer lengths of hospital stay and were more likely to be discharged to a nursing home.
  • Although surgery was similar in both groups, differences in hip fracture care were most evident during the postoperative period, which is a critical time for recovering mobility and functional independence.

Given that hip fractures remain one of the leading causes of disability and mortality among older adults, there is a critical need to address these gaps to better serve linguistically diverse populations of older adults presenting with hip fracture.

It is crucial that older patients who speak nondominant languages do not experience potentially preventable adverse outcomes and have the same opportunity for recovery and discharge home after hip fracture as those who speak dominant languages.

“Our study builds on existing research that shows patients who do not speak English tend to have longer hospital stays. However, to our knowledge, this is the first study to highlight that non-English speakers are more likely to experience delirium during hospitalization and to be transferred to a nursing home after hip fracture surgery,” says Dr. Christina Reppas-Rindlisbacher, lead author of the study. “The results of our study will hopefully prompt hospitals to increase access to interpretation services, improve staff training to address implicit bias and set institutional standards for multilingual care.”

To read the full study, click here.