Emergency department utilization patterns and health care needs assessment among parents of Chinese American children in New York City.

A limited number of publications have addressed the health care needs of Chinese American children of recently immigrated parents. We administered a Chinese-language survey to parents presenting to an urban pediatric emergency department (PED) in New York City and at community venues. The survey assessed demographics, access to health care, and utilization/expectations of the PED. Emergency Severity Index scores were recorded for emergency department patients. Three hundred fifteen families (54% in the PED) completed the survey. Of those completed in the PED, 79% sought emergency services because of pediatric referral or because their pediatrician's office was closed. Of our sickest patients with an Emergency Severity Index score of 3 or less, 28% of parents felt that the child was somewhat sick or not sick at all. Although the majority of our Chinese American families utilize the emergency department appropriately, 28% of the parents of our sickest patients did not appreciate the degree of illness of their children.

A comparison of the influence of hospital-trained, ad hoc, and telephone interpreters on perceived satisfaction of limited English-proficient parents presenting to a pediatric emergency department.

BACKGROUND: Latinos are the fastest growing minority group in the United States with a significant percentage of this population having limited English proficiency. OBJECTIVE: To determine whether mode of interpretation influences satisfaction of limited English-proficient parents presenting to a tertiary care pediatric emergency department. DESIGN: One hundred eighty parents of patients presenting to a pediatric emergency department were surveyed after receiving services from one of the following interpreters: hospital-trained, ad hoc, or telephone. An English-proficient comparison group of 60 parents of any ethnicity was also surveyed (total N = 240). RESULTS: Parents were significantly more satisfied (P < 0.001) with hospital-trained interpreters. While no significant difference was found in overall visit satisfaction, there were significant differences in several other outcome variables. When hospital-trained interpreters were used, parents were significantly more satisfied (P < 0.001) with their physicians and nurses. With regard to the ability to communicate with pediatric emergency department personnel, parents using hospital-trained interpreters averaged significantly higher scores (P < 0.001) than the telephone group. Quality-of-care scores were significantly higher (P < 0.001) for parents assigned to hospital-trained interpreters than for the other forms of interpretation. English-proficient parents scored highest in the following categories: ability to communicate, quality of care, and overall visit satisfaction. Parents using hospital-trained interpreters scored higher than English-proficient parents when questioned about physician and nursing satisfaction. CONCLUSION: Hospital-trained interpreters are a valuable and needed resource to facilitate communication with limited English-proficient patients and families. Other interpretation services are useful but have limitations.