Patterns of Interpreter Use for Hospitalized Patients with Limited English Proficiency
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Professional interpreter use improves the quality of care for patients with limited English proficiency (LEP), but little is known about interpreter use in the hospital.
Evaluate interpreter use for clinical encounters in the hospital.
Hospitalized Spanish and Chinese-speaking LEP patients.
Patient reported use of interpreters during hospitalization.
Among 234 patients, 57% reported that any kind of interpreter was present with the physician at admission, 60% with physicians during hospitalization, and 37% with nurses since admission. The use of professional interpreters with physicians was infrequent overall (17% at admission and 14% since admission), but even less common for encounters with nurses (4%, p < 0.0001). Use of a family member, friend or other patient as interpreter was more common with physicians (28% at admission, 23% since admission) than with nurses (18%, p = 0.008). Few patients reported that physicians spoke their language well (19% at admission, 12% since admission) and even fewer reported that nurses spoke their language well (6%, p = 0.0001). Patients were more likely to report that they either “got by” without an interpreter or were barely spoken to at all with nurses (38%) than with physicians at admission (14%) or since admission (15%, p < 0.0001).
Interpreter use varied by type of clinical contact, but was overall more common with physicians than with nurses. Professional interpreters were rarely used. With physicians, use of ad hoc interpreters such as family or friends was most common; with nurses, patients often reported, “getting by” without an interpreter or barely speaking at all.
- Baker, DW, Hayes, R, Fortier, JP (1998) Interpreter use and satisfaction with interpersonal aspects of care for Spanish-speaking patients. Med Care 36: pp. 1461-1470 CrossRef
- Jacobs, EA, Lauderdale, DS, Meltzer, D, Shorey, JM, Levinson, W, Thisted, RA (2001) Impact of interpreter services on delivery of health care to limited-English-proficient patients. J Gen Intern Med 16: pp. 468-474 CrossRef
- Karliner, LS, Jacobs, EA, Chen, AH, Mutha, S (2007) Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health Serv Res 42: pp. 727-754 CrossRef
- Chen, A, Youdelman, MK, Brooks, J (2007) The Legal Framework for Language Access in Healthcare Settings: Title VI and Beyond. J Gen Intern Med 22: pp. 362-367 CrossRef
- Perkins J. Ensuring Linguistic Access in Health Care Settings: An Overview of Current Legal Rights and Responsibilities: Kaiser Commission of Medicaid and the Uninsured; 2003.
- National Standards for Culturally and Linguistically Appropriate Services in Health Care: U.S. Department of Health and Human Services, Office of Minority Health; 2001.
- Wilson-Stronks A, Galvez, E. Hospitals, Language and Culture: A Snapshot of the Nation. Exploring Cultural and Linguistic Services in the Nations Hospitals: A Report of Findings: The Joint Commission and The California Endowment; 2007.
- Baker, DW, Parker, RM, Williams, MV, Coates, WC, Pitkin, K (1996) Use and effectiveness of interpreters in an emergency department. Jama 275: pp. 783-788 CrossRef
- Flores, G, Torres, S, Holmes, LJ, Salas-Lopez, D, Youdelman, MK, Tomany-Korman, SC (2008) Access to hospital interpreter services for limited English proficient patients in new jersey: a statewide evaluation. J Health Care Poor Underserved 19: pp. 391-415 CrossRef
- Lee, KC, Winickoff, JP, Kim, MK (2006) Resident physicians' use of professional and nonprofessional interpreters: a national survey. Jama 296: pp. 1050-1053 CrossRef
- Diamond, LC, Schenker, Y, Curry, L, Bradley, EH, Fernandez, A (2009) Getting by: underuse of interpreters by resident physicians. J Gen Intern Med 24: pp. 256-262 CrossRef
- Burbano O'Leary, SC, Federico, S, Hampers, LC (2003) The truth about language barriers: one residency program's experience. Pediatrics 111: pp. e569-e573 CrossRef
- Schenker, Y, Lo, B, Ettinger, KM, Fernandez, A (2008) Navigating language barriers under difficult circumstances. Ann Intern Med 149: pp. 264-269
- Brodaty, H, Low, LF, Gibson, L, Burns, K (2006) What is the best dementia screening instrument for general practitioners to use?. Am J Geriatr Psychiatry 14: pp. 391-400 CrossRef
- Karliner, LS, Napoles-Springer, AM, Schillinger, D, Bibbins-Domingo, K, Perez-Stable, EJ (2008) Identification of limited English proficient patients in clinical care. J Gen Intern Med 23: pp. 1555-1560 CrossRef
- Sangha, O, Stucki, G, Liang, MH, Fossel, AH, Katz, JN (2003) The Self-Administered Comorbidity Questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis Rheum 49: pp. 156-163 CrossRef
- Kuo, DZ, O'Connor, KG, Flores, G, Minkovitz, CS (2007) Pediatricians' use of language services for families with limited English proficiency. Pediatrics 119: pp. e920-e927 CrossRef
- Cohen, AL, Rivara, F, Marcuse, EK, McPhillips, H, Davis, R (2005) Are language barriers associated with serious medical events in hospitalized pediatric patients?. Pediatrics 116: pp. 575-579 CrossRef
- Schyve, P (2007) Language differences as a barrier to quality and safety in health care: The joint commission perspective. J Gen Intern Med 22: pp. 360-361 CrossRef
- Karliner LS, Mutha S. Achieving quality in health care through language access services: lessons from a California public hospital. Am J Med Qual 2010 Jan-Feb; 25:51–9.
- Divi, C, Koss, RG, Schmaltz, SP, Loeb, JM (2007) Language proficiency and adverse events in US hospitals: a pilot study. Int J Qual Health Care 19: pp. 60-67 CrossRef
- Karliner LS, Kim SE, Meltzer DO, Auerbach AD. Influence of language barriers on outcomes of hospital care for general medicine inpatients. J Hosp Med 2010 May-June; 5:276–82.
- Patterns of Interpreter Use for Hospitalized Patients with Limited English Proficiency
Journal of General Internal Medicine
Volume 26, Issue 7 , pp 712-717
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- language proficiency
- interpreter use
- non-English-speaking patients
- Industry Sectors
- Author Affiliations
- 2. Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- 1. Medical Effectiveness Research Center for Diverse Populations, Division of General Internal Medicine, Department of Medicine, University of California, 0856, 3333, California Street, San Francisco, CA, 94143 – 085, USA