Reducing avoidable hospital readmissions and improving patient experience scores are two of the top priorities for hospital and clinic leadership. Both depend on something that rarely makes it into the strategic plan: whether patients actually understood the discharge instructions, patient education materials, and forms they were handed.
The Patient Comprehension Gap
The numbers are more concerning than most administrators assume. Nearly 40% of discharged patients misunderstand the medication instructions they receive when leaving the hospital, and close to half can't correctly explain their own diagnosis or the follow-up care they need. This isn't a niche problem affecting only patients with limited English proficiency: the American Medical Association, the NIH, and the CDC all recommend that patient materials be written at or below a sixth-grade reading level, yet in practice many exceed that recommendation by as much as four grade levels, even in English.
When patients don't understand what they're told, they don't follow the plan, whether that means taking medication correctly, showing up for follow-up care, or recognizing a warning sign early.
How Poor Patient Communication Drives Up Readmission Costs
This is where comprehension turns into a line item on a hospital's budget. A 2017 study published in Medical Care found that when convenient access to clear communication support was in place, 30-day readmission rates for patients dropped from 17.8% to 13.4%, averting an estimated 119 readmissions over eight months and generating estimated hospital savings of $161,404 per month.
A separate study in the Journal of General Internal Medicine, covering 3,071 patients, found that those who received professional language support at both admission and discharge had an average length of stay of 2.6 days, compared to 5.1 days for those who received none. And a health-literacy initiative at a pediatric hospital reduced 30-day readmissions from 12.3% to 10.5% simply by adjusting discharge materials to caregivers' comprehension level.
None of these interventions were about clinical treatment. They were about whether the patient understood what they were told, and whether the materials they took home actually worked for them.
Healthcare Content Localization: Beyond Translation, and Not Just a U.S. Issue
The instinct is often to treat this as a translation problem: convert the English document into another language, word for word. But patient comprehension depends on more than vocabulary. It depends on reading level, cultural framing, format, and whether the content was built for the audience receiving it, not just converted from the one it was written for. That's the difference between translation and healthcare content localization.
This isn't only a U.S. consideration. In the UK, roughly 8% of the population of England and Wales, about 4.2 million people, don't have English as a first language. The NHS carries a legal duty under the Equality Act 2010 to provide accessible, inclusive communications, and official UK government guidance explicitly advises healthcare providers to avoid using Google Translate to produce medical materials. In Canada, Ontario's French Language Services Act legally requires designated hospitals and health service providers to offer materials in French at a quality equivalent to English, not a lesser, machine-generated version of it.
The common thread across these systems is that patient-facing content is treated as part of clinical quality, not as an afterthought handled by whoever has a few spare hours and a translation tool.
Patient Communication as a Return on Investment, Not a Compliance Cost
For hospital and clinic leadership, this reframes localization from a compliance line item to an investment with a measurable return: fewer avoidable readmissions, fewer follow-up calls to clarify confusing instructions, and better patient experience scores, which in systems like the U.S. also affect reimbursement.
In practice, that means discharge instructions, patient education materials, consent forms, and the hospital's own website adapted, not just translated, for the languages, reading levels, and abilities of the patients actually walking through the door. That includes screen reader-friendly websites, closed captioning, audio description, accessible document formats, and sign language-integrated video, the kind of language accessibility and inclusive communication that keeps institutions aligned with standards like WCAG and Section 508 while making content genuinely usable for every patient. At Arcadia, we build this work into the same certified, ISO-aligned, HIPAA-compliant workflows we use for regulated clinical documentation.
The patients who don't come back for the right reasons, because they got better, are the ones every institution wants. The ones who come back because they never understood the plan in the first place are the ones a clearer patient communication strategy can prevent.
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References:
1. Kripalani, S., et al., cited in "Recognizing and Addressing Health Literacy Barriers."
2. American Journal of Medical Quality, cited in "Recognizing and Addressing Health Literacy Barriers."
3. Karliner, L.S., Perez-Stable, E.J., Gregorich, S.E. "Convenient Access to Professional Interpreters in the Hospital Decreases Readmission Rates and Estimated Hospital Expenditures for Patients With Limited English Proficiency."
4. Lindholm, M., et al. "Professional Language Interpretation and Inpatient Length of Stay and Readmission Rates."
5. "Health literacy initiative improves discharge education, readmission rates."
6. GOV.UK. "Language interpreting and translation: migrant health guide."
8. Government of Ontario. *French Language Services Act, R.S.O. 1990.