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January 24, 2008Language Barriers in Health Care |
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From The Commonwealth Fund: Approximately 47 million people in the United States speak a language other than English at home, and more than 21 million have problems speaking or understanding English, according to the 2000 census. When seeking health care, patients with limited English proficiency (LEP) often have worse access to care and lower satisfaction levels compared with English speakers. A special supplementary issue of the Journal of General Internal Medicine (Nov. 2007), which includes three Commonwealth Fundsupported articles, examines language barriers in health care. While it has been shown that interpreting for LEP individuals can improve doctor--patient communication and facilitate the delivery of high-quality care, little is known about the relative effectiveness of different interpreting methods. The interpreter can be located in the room with the provider and patient (proximate interpretation), or outside the room and linked to the physician and patient via telecommunication (remote interpretation). The authors find that "encounters were more accurately and quickly interpreted with RSMI than with the more commonly used methods" of remote consecutive medical interpreting, proximate consecutive medical interpreting, and proximate ad hoc interpreting (a common method that uses family or friends of patients or untrained hospital staff). For example, the researchers' analysis shows the non-RSMI interpreting approaches were associated with a 12-fold greater rate of potential medical errors of moderate or greater clinical significance, compared with RSMI. Patients with language-concordant providers received usual care. In "Providing High-Quality Care for Limited English Proficient Patients: The Importance of Language Concordance and Interpreter Use," Quyen Ngo-Metzger, M.D., M.P.H., of the University of California, Irvine School of Medicine, and colleagues find that LEP Chinese and Vietnamese patients in cities throughout the United States reported receiving less health education and worse interpersonal care when compared with patients with language-concordant providers.
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