Multicultural Transitions: Caregiver Presence and Language-Concordance at Discharge

Introduction: Patients with low health literacy (HL) and minority patients encounter many challenges during hospital to community transitions. We assessed care transitions of minority patients with various HL levels and tested whether presence of caregivers and provision of language-concordant care are associated with better care transitions. 

Methods: A prospective cohort study of 598 internal medicine patients, Hebrew, Russian, or Arabic native speakers, at a tertiary medical center in central Israel, from 2013 to 2014. 

HL was assessed at baseline with the Brief Health Literacy Screen. A follow-up telephone survey was used to administer the Care Transition Measure [CTM] and to assess, caregiver presence and patient–provider language-concordance at discharge. 

Results: Patients with low HL and without language-concordance or caregiver presence had the lowest CTM scores (33.1, range 0–100). When language-concordance and caregivers were available, CTM scores did not differ between the medium-high and low HL groups (68.7 and 66.9, respectively, p = 0.118). The adjusted analysis, showed that language-concordance and caregiver presence during discharge moderate the relationship between HL and patients’ care transition experience (p < 0.001). 

Conclusions: Language-concordance care and caregiver presence are associated with higher patients’ ratings of the transitional-care experience among patients with low HL levels and among minorities.