ArticlePediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2026
Children From Families Speaking Languages Other Than English or Spanish, Medical Complexity and PICU Utilization: Single-Center Retrospective Study, 2015-2022.
Article in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesChildren with medical complexity (CMC) account for a disproportionate share of PICU utilization. Children from families speaking languages other than English (LOE) face barriers that may influence critical-care needs. We sought to evaluate the intersection of language and PICU utilization of CMC.
designRetrospective cohort study.
settingLarge quaternary children's hospital in the United States, from 2015 to 2022. PATIENTS: CMC, defined as having two or more body systems involved in a complex chronic condition (CCC), admitted to a children's hospital. Patient family language categorized as English, Spanish, or languages other than English or Spanish (LOES).
interventionsNone. MEASUREMENTS AND MAIN
resultsWe identified 3096 unique CMC (54% male) accounting for 9297 hospital encounters (mean age 8.2 yr). Among patient families, 7.2% had a preferred LOE, with 2.7% speaking Spanish and 4.6% speaking LOES. Around one-third (35%) of patients had a PICU admission during at least one encounter. Mixed-effects regressions with patient-specific random effects were used to model associations. LOES was associated with greater odds of PICU admission (adjusted odds ratio 1.58; 95% CI, 1.1-2.2) and longer PICU length of stay (incidence-rate ratio 2.4; 95% CI, 1.7-3.5) after adjusting for age, sex, race, Child Opportunity Index (COI) and the number of CCC.
conclusionsIn patients admitted to our children's hospital (2015-2022), the CMC from families speaking a LOES represented a vulnerable subgroup, with associated greater odds of PICU admission and longer stays. These disparities persisted after accounting for CCCs and COI. Timely, language-concordant communication-especially for less common languages-may mitigate aspects of critical care admission in this population.
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