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Providing High-Quality Care for Limited English Proficient Patients: The Importance of Language Concordance and Interpreter Use
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Original Article
Providing High-Quality Care for Limited English Proficient Patients: The Importance of Language Concordance and Interpreter
Use
Quyen Ngo-Metzger1  , Dara H. Sorkin1, Russell S. Phillips2, Sheldon Greenfield1, Michael P. Massagli3, Brian Clarridge4 and Sherrie H. Kaplan1
| (1) |
Division of General Internal Medicine and Primary Care and the Center for Health Policy Research, University of California, Irvine School of Medicine, Research, 111 Academy, Suite 220, Irvine, CA, USA |
| (2) |
Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA |
| (3) |
Dana Farber Cancer Institute, Boston, MA, USA |
| (4) |
The Center for Survey Research, University of Massachusetts-Boston, Boston, MA, USA |
Published online: 24 October 2007
Abstract
Background Provider–patient language discordance is related to worse quality care for limited English proficient (LEP) patients who speak
Spanish. However, little is known about language barriers among LEP Asian-American patients.
Objective We examined the effects of language discordance on the degree of health education and the quality of interpersonal care that
patients received, and examined its effect on patient satisfaction. We also evaluated how the presence/absence of a clinic
interpreter affected these outcomes.
Design Cross-sectional survey, response rate 74%.
Participants A total of 2,746 Chinese and Vietnamese patients receiving care at 11 health centers in 8 cities.
Measurements Provider–patient language concordance, health education received, quality of interpersonal care, patient ratings of providers,
and the presence/absence of a clinic interpreter. Regression analyses were used to adjust for potential confounding.
Results Patients with language-discordant providers reported receiving less health education ( β = 0.17, p < 0.05) compared to those with language-concordant providers. This effect was mitigated with the use of a clinic interpreter.
Patients with language-discordant providers also reported worse interpersonal care ( β = 0.28, p < 0.05), and were more likely to give low ratings to their providers (odds ratio [OR] = 1.61; CI = 0.97–2.67). Using a clinic
interpreter did not mitigate these effects and in fact exacerbated disparities in patients’ perceptions of their providers.
Conclusion Language barriers are associated with less health education, worse interpersonal care, and lower patient satisfaction. Having
access to a clinic interpreter can facilitate the transmission of health education. However, in terms of patients’ ratings
of their providers and the quality of interpersonal care, having an interpreter present does not serve as a substitute for
language concordance between patient and provider.
KEY WORDS quality of care - satisfaction - interpersonal care - interpreters - health education - language barriers - limited English proficiency - Asian American
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