SpringerLink - Journal Article

Original Article

Patient Satisfaction with Different Interpreting Methods: A Randomized Controlled Trial

Francesca Gany¹, Jennifer Leng¹, Ephraim Shapiro¹, David Abramson², Ivette Motola³, David C. Shield⁴ and Jyotsna Changrani¹

(1)	Center for Immigrant Health, Department of Medicine, New York University School of Medicine, 550 First Avenue, OBV, CD-401, New York, NY, USA

(2)	Columbia University Mailman School of Public Health, New York, NY, USA

(3)	Jackson Memorial Medical Center, University of Miami, Coral Gables, FL, USA

(4)	Yale University School of Medicine, New Haven, CT, USA

Published online: 24 October 2007

Abstract

Background Growth of the foreign-born population in the U.S. has led to increasing numbers of limited-English-proficient (LEP) patients. Innovative medical interpreting strategies, including remote simultaneous medical interpreting (RSMI), have arisen to address the language barrier. This study evaluates the impact of interpreting method on patient satisfaction.

Methods 1,276 English-, Spanish-, Mandarin-, and Cantonese-speaking patients attending the primary care clinic and emergency department of a large New York City municipal hospital were screened for enrollment in a randomized controlled trial. Language-discordant patients were randomized to RSMI or usual and customary (U&C) interpreting. Patients with language-concordant providers received usual care. Demographic and patient satisfaction questionnaires were administered to all participants.

Results 541 patients were language-concordant with their providers and not randomized; 371 were randomized to RSMI, 167 of whom were exposed to RSMI; and 364 were randomized to U&C, 198 of whom were exposed to U&C. Patients randomized to RSMI were more likely than those with U&C to think doctors treated them with respect (RSMI 71%, U&C 64%, p < 0.05), but they did not differ in other measures of physician communication/care. In a linear regression analysis, exposure to RSMI was significantly associated with an increase in overall satisfaction with physician communication/care (β 0.10, 95% CI 0.02–0.18, scale 0–1.0). Patients randomized to RSMI were more likely to think the interpreting method protected their privacy (RSMI 51%, U&C 38%, p < 0.05). Patients randomized to either arm of interpretation reported less comprehension and satisfaction than patients in language-concordant encounters.

Conclusions While not a substitute for language-concordant providers, RSMI can improve patient satisfaction and privacy among LEP patients. Implementing RSMI should be considered an important component of a multipronged approach to addressing language barriers in health care.

KEY WORDS immigrant health - satisfaction - language

Francesca Gany
Email: fg12@nyu.edu

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