2026 Theses Doctoral

Impact of Linguistic Acculturation on Hospital Readmission Among Patients Evaluated for Acute Coronary Syndrome

Romero, Emily Kyana

Hospital readmissions remain a significant concern for patients and the United States healthcare system, given their association with increased morbidity, mortality, and financial burden. Prior research has examined disparities in clinical outcomes across racial and ethnic groups; however, less is known about linguistic acculturation’s role in post-hospital outcomes.

As such, the present study used time-to-event analyses to examine incidence of all-cause 1-year hospital readmission among linguistically acculturating adults following evaluation for acute coronary syndrome. Participants were categorized into three groups (novice, intermediate, or advanced) based on self-reported English fluency and language background. Secondarily, four health behaviors (physical activity, sleep, medication adherence, and smoking) were assessed as potential mediators in the relationship between linguistic acculturation and hospital readmission.

Findings indicated that lower linguistic acculturation was associated with reduced readmission risk during the early post-discharge period. This pattern did not persist over later follow-up. By one year, differences in disease severity measures partially explained variation in readmission risk across groups. There was insufficient evidence to support mediation by health behaviors. The observed reduction in readmission among less acculturated individuals is believed to reflect differences in health-seeking behaviors rather than improved health status.

Overall, this study identified linguistic acculturation as an important factor in post-hospital trajectory. Future work should examine mechanisms underlying disparities in readmission among acculturating individuals residing in the United States and their implications for long-term health outcomes. Targeted health promotion efforts may help address these patterns by improving care-seeking decisions, particularly regarding the use of primary versus emergency care services.