Date of Completion

2025

Document Type

Honors College Thesis

Department

Neuroscience

Thesis Type

College of Arts and Science Honors, Honors College

First Advisor

Dr. Joseph Kennedy

Keywords

Medicine, Health Equity, Language, Patient Experience

Abstract

Introduction: Healthcare is a dynamic field, dependent on the continuous evolution of its practices to best serve communities and adapt to shifts in populations, resources, and innovations. Patients with limited English proficiency (LEP) are considered a protected patient population. Protected populations in healthcare are individuals who historically receive inferior care compared to more privileged groups due to systemic neglect. Efforts in the U.S. healthcare system to improve care for patients with LEP include, but are not limited to, translation services, increased funding for patient and family advocacy services, and the engagement of community leaders as consultants. While these resources have proven effective in certain aspects of patient care, measurable gaps in health equity persist, particularly in the emergency department (ED) setting. National trends indicate that a variety of clinical outcomes are impacted by LEP status, including increased admission and medical imaging rates, longer hospital length of stay (LOS), higher obstetric trauma rates, decreased pain control, extended ED wait times, and increased revisitation rates within 72 hours post-discharge for similar complaints. Vermont’s emergency medical system is primarily reliant on a single healthcare organization. The University of Vermont Health Network (UVMHN) is the controlling shareholder in healthcare for northern Vermont and northeastern New York. The University of Vermont Medical Center (UVMMC), located in Burlington, Vermont, is the sole Level I trauma center within a 100-mile radius. It serves as the primary Emergency Department tasked with treating Vermont’s most populous county, Chittenden County. Chittenden County is home to 169,000 of Vermont’s 650,000 residents. UVMMC has experienced a 62% increase (Figure 1) in the number of patients with LEP presenting to its ED over the past five years. As the demographics of UVMMC’s patient population shift, it is imperative to continuously adapt care to best serve all patients.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

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