Community-Level Predictors of Missed Callbacks in Geriatric ED Patients With Limited English Proficiency

Background: Missed follow-up calls after an emergency department (ED) visit are common among geriatric patients with limited English proficiency (LEP) and is influenced by social determinants of health.This quality improvement (QI) project examines the relationship between Social Vulnerability Index (SVI) and ED callback success rate to inform strategies for improving post-discharge care.Methods: A retrospective QI analysis of ED discharge data for LEP geriatric patients (age 65) discharged between June 2024-June 2025 was conducted.Variables (age, sex, race, payor, zip code, and callback success (yes/no) rate) were selected after a review of literature in PubMed from 1998-2024.Physician Associates conducted follow-up calls within 24-48 hours using a structured script.Descriptive statistics and logistic regression assessed callback success rate by zip-code-linked SVI.Results: Among 1,606 patients, most were female (64.8%),Hispanic (89.0%), and classified as 'Other' race (82.3%), with the majority insured through Medicare Managed Care (74.0%).The mean age was 76.6 2.7 years, and half (50.2%) were successfully contacted.Mean SVI was 0.979 0.053.While the difference was not statistically significant, the prediction plots suggested a trend of lower callback success rates in high-SVI regions.A Mann-Whitney U test (Z = -1.93,p > 0.05) showed a non-significant trend toward higher callback success rates among younger patients.No difference was observed by sex, race, insurance type, or ethnicity. Conclusion:Although not statistically significant as a predictor, SVI may inform effective outreach strategies.An adjusted model is ongoing, and future steps will explore if patterns persist across EDs within the health system.