Patterns of Interpreter Use for Hospitalized Patients with Limited English Proficiency
ABSTRACT
BACKGROUND
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.
OBJECTIVE
Evaluate interpreter use for clinical encounters in the hospital.
DESIGN
Cross-sectional.
PARTICIPANTS
Hospitalized Spanish and Chinese-speaking LEP patients.
MAIN MEASURES
Patient reported use of interpreters during hospitalization.
KEY RESULTS
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).
CONCLUSIONS
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.
KEY WORDS
language proficiency interpreter use non-English-speaking patientsNotes
Acknowledgements
This study was supported by grant no. 20061003 from The California Endowment and by grant no. P30-AG15272 of the Resource Centers for Minority Aging Research program funded by the National Institute on Aging, National Institutes of Health. Dr. Schenker was supported by the General Internal Medicine Fellowship at UCSF, funded by the Department of Health and Human Services, Health Resources and Services Administration (DHHS HRSA D55HP05165), and then by a Junior Faculty Career Development Award from the National Palliative Care Research Center. We thank Steven Gregorich for statistical advice, Gabriel Somma, Monica Lopez and Julissa Saavedra for data collection and management, and the staff and physicians at the Alameda County Medical Center for their participation.
Conflict of Interest
None disclosed.
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