CALD Patients’ Length of Stay and Unplanned Readmissions: An exploratory review of international literature and Alfred Health Services [A Participatory Field Placement Collaboration Report by La Trobe University Department of Public Health and Alfred Health Language Services] Report uri icon


  • Purpose: (1) To consider international literature with regard to Culturally and Linguistically Diverse (CALD) patients and length of stay (LOS) and/or unplanned readmissions; (2) To consider Alfred Health CALD data and factors that might affect LOS and/or readmissions for CALD patients. Literature: There is limited empirical research/literature addressing the topic area in Australia or internationally. The quality of the international research/literature, suggesting that CALD or Limited English Proficiency (LEP) patients LOS is longer, or that there are increased unplanned readmissions, was graded by the current researchers as being overall ‘week’ due to the type of research. In addition, between the various literature assessed, there were conflicting findings — nevertheless these studies provided some useful evidence and insights to assess the topic and related issues. Results: (1) Studies indicated varied results—some indicating CALD/LEP patients LOS is longer and/or readmissions greater, while other studies suggest there is no difference when compared to English proficient patients (EP); (2) The majority of studies however revealed moderate to strong findings to support the use and increase of professional interpreter services to help ensure reduced occasions of service of CALD and LEP patients; (3) Alfred Health’s data collection regarding CALD/LEP patients is minimal and limits comparisons with literature; (4) However ‘overall’ data comparing CALD and non-CALD patients suggests increased LOS and unplanned readmissions among Alfred Health CALD patients (2013 – 2016); (5) International literature indicates a number of possible causes: (a) social determinants, (b) communication failures, (c) untrained / adhoc interpreters (family members and bilingual staff) versus (d) utilisation of professional interpreters and (e) LEP impact on health related outcomes; (6) The majority of studies recommend that additional data/research is required. Recommendations & Limitations: (1) This report is an exploratory report only and thus restricts conclusions / recommendations or the development of policy due to the limitations of international empirical data, minimal Alfred Health data and tapered report criteria; (2) However these limitations provide a basis for recommendations: (a) additional research needs to be undertaken and funded, (b) requirement for more extensive Alfred CALD and LEP data collection and (c) the need for proper cost analysis of CALD / LEP LOS and readmission; (3) Given that CALD / LEP issues are recurrent in a number of countries, professional interpreter utilisation needs to be considered a proactive priority for patient beneficence and Alfred Health efficiency.

publication date

  • 2016