Oral Presentation Australian and New Zealand Stroke Organisation Conference 2025

Evaluating the association between language discordance and stroke rehabilitation outcomes: a national registry study   (123113)

Christine T Shiner 1 2 3 , Jane Wu 1 2 , Yuriko Watanabe 1 2 , Tara Alexander 4 , Vijaya Sundararajan 3 5
  1. Department of Rehabilitation, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia
  2. School of Clinical Medicine, University of New South Wales, Sydney , NSW, Australia
  3. Health Equity Research, St Vincent's Health Australia, Sydney , NSW, Australia
  4. Australasian Rehabilitation Outcomes Centre, University of Wollongong, Wollongong, NSW, Australia
  5. Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia

Background/Aims: Language discordance can compromise patient-provider communication and impact care quality and outcomes for linguistic minorities. This study aimed to evaluate whether stroke rehabilitation outcomes differed according to the need for an interpreter in a large national rehabilitation dataset. 

Methods: A retrospective, observational study was conducted using data captured by the Australasian Rehabilitation Outcomes Centre (AROC) benchmarking registry. Episodes of adult, inpatient rehabilitation delivered in an Australian public hospital over a 12-month period were included. Between-group and multivariable regression analyses were used to examine associations between ‘needing an interpreter’ and rehabilitation characteristics. 

Results: N=7735 patient episodes of stroke rehabilitation were included; of these, n=532 (6.9%) required an interpreter. On admission to rehabilitation, those requiring interpreters had lower Functional Independence Measure (FIM) scores (median 61[41-80] vs 71[47-91]) and a greater likelihood of comorbidities (57% vs 50%, p’s<0.001). Needing an interpreter was associated with a longer rehabilitation length-of-stay (median 3 additional days), greater likelihood of complication(s) (39% vs 31%) and lower discharge FIM score (91[71-104] vs 101[74-114]; p’s<0.001). In multivariable models, needing an interpreter was not associated with functional gains in rehabilitation, when controlling for casemix and length-of-stay.

Conclusion: Approximately 1 in 15 Australian stroke patients accessing public inpatient rehabilitation required an interpreter. Those requiring interpreters were more functionally dependent at rehabilitation admission and discharge, had longer admissions, and were more likely to experience complications; yet, they achieved similar functional gains. These findings suggest greater case acuity, but similar functional improvements, for stroke patients who experience language discordance in inpatient rehabilitation.