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Too Little Information: Accessibility of Information About Language Services on Hospital Websites

Journal of Immigrant and Minority Health volume 22, pages 433–438 (2020)Cite this article

Abstract

Hospital websites are an important resource to patients with limited English proficiency (LEP) seeking information about a facility’s language assistance services. We sought to identify the types of such services described on hospital websites in a diverse state and compare them by hospital characteristics. Washington State acute care hospital websites were systematically reviewed in February 2018 for translated content and information about language assistance services. Hospital characteristics included annual admissions and revenue, bed size and the proportion of populations with LEP in the hospital’s county. Of 93 hospitals, 10.8% provided translated websites. Interpreter services were mentioned on 81.7% of websites; access required navigation through 1–4 English webpages. Larger bed-size, higher revenue, and more admissions were positively associated with providing language services information (p < 0.01), whereas county-level population with LEP was not (p = 0.17). Many hospital websites are not translated or lack easily accessible information about language assistance services and consequently may not be a useful resource to patients with LEP.

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References

  1. Pandya C, McHugh M, Batalova J. Limited English proficient individuals in the United States: number, share, growth, and linguistic diversity. Migration Policy Institute: LEP Data Brief; 2011.

    Google Scholar 

  2. Batalova J, Zong J. Language diversity and English proficiency in the United States. Migr Inform Source. 2016;14:2017.

    Google Scholar 

  3. Jang Y, Kim MT. Limited English proficiency and health service use in Asian Americans. J Immigr Minor Health. 2019;21(2):264–70.

    Article  Google Scholar 

  4. Njeru JW, St. Sauver JL, Jacobson DJ, Ebbert JO, Takahashi PY, Fan C, et al. Emergency department and inpatient health care utilization among patients who require interpreter services. BMC Health Serv Res. 2015;15(1):214.

    Article  Google Scholar 

  5. Ngai KM, Grudzen CR, Lee R, Tong VY, Richardson LD, Fernandez A. The association between limited English proficiency and unplanned emergency department revisit within 72 hours. Ann Emerg Med. 2016;68(2):213–21.

    Article  Google Scholar 

  6. Derose KP, Baker DW. Limited English proficiency and Latinos’ use of physician services. Med Care Res Rev. 2000;57(1):76–91.

    Article  CAS  Google Scholar 

  7. Sarver J, Baker DW. Effect of language barriers on follow-up appointments after an emergency department visit. J Gen Intern Med. 2000;15(4):256–64.

    Article  CAS  Google Scholar 

  8. Columbia Legal Services. Access denied: Washington’s Charity Care System, its shortfalls, and the effect on low-income patients. Seattle, WA: Columbia Legal Services; 2017.

    Google Scholar 

  9. Washington State Legislature, Concerning state charity care law (SB 6273 - 2017-18), 2018.

  10. Jacobs E, Chen AH, Karliner LS, Agger-Gupta N, Mutha S. The need for more research on language barriers in health care: a proposed research agenda. Milbank Q. 2006;84(1):111–33.

    Article  Google Scholar 

  11. Sentell T, Braun KL. Low health literacy, limited English proficiency, and health status in Asians, Latinos, and other racial/ethnic groups in California. J Health Commun. 2012;17(3):82–99.

    Article  Google Scholar 

  12. Sangaramoorthy T, Guevara EM. Immigrant health in rural Maryland: a qualitative study of major barriers to health care access. J Immigr Minor Health. 2017;19(4):939–46.

    Article  Google Scholar 

  13. Kreuter MW, Farrell DW, Olevitch LR, Brennan LK. Tailoring health messages: customizing communication with computer technology. London: Routledge; 2013.

    Book  Google Scholar 

  14. Title VI of the civil rights act of 1964. https://www.justice.gov/crt/title-vi-civil-rights-act-1964-42-usc-2000d-et-seq

  15. Lau v. Nichols, 414 U.S. 563, (1974).

  16. Affordable Care Act of 2010. Section 1557: ensuring meaningful access for individuals with limited English proficiency. https://www.hhs.gov/sites/default/files/1557-fs-lep-508.pdf.

  17. Executive order no. 13166, Improving access to services for persons with limited English proficiency, and resulting agency guidance, national origin discrimination includes discrimination because of limited English proficiency (LEP). 3 CFR 13166 (2000).

  18. Nondiscrimination in Health Programs and Activities. 2016. https://www.federalregister.gov/documents/2016/05/18/2016-11458/nondiscrimination-in-health-programs-and-activities.

  19. Fox S, Duggan M. Pew Research Center Internet Project. 2013. https://www.pewinternet.org/2013/01/15/health-online-2013.

  20. Jin LX, Ibrahim AM, Newman NA, Makarov DV, Pronovost PJ, Makary MA. Robotic surgery claims on United States hospital websites. J Healthc Qual. 2011;33(6):48–52.

    Article  Google Scholar 

  21. Kincaid ML, Fleisher LA, Neuman MD. Presentation on US hospital websites of risks and benefits of transcatheter aortic valve replacement procedures. JAMA Intern Med. 2015;175(3):440–1.

    Article  Google Scholar 

  22. United States Census Bureau. 2012–2016 American Community Survey 5-year estimates. 2016.

  23. United States Census Bureau. American Community Survey 1-year estimates detailed tables, 2018.

  24. Washington State Office of Financial Management. Limited English proficiency population estimate methodology. https://www.ofm.wa.gov/sites/default/files/public/legacy/pop/subject/ofm_pop_limited_english_proficiency_methodology.pdf.

  25. Cuzick J. A Wilcoxon-type test for trend. Stat Med. 1985;4(1):87–90.

    Article  CAS  Google Scholar 

  26. Das P, Kuznetsova A, Zhu M, Milanaik R. Dangers of machine translation: the need for professionally translated anticipatory guidance resources for limited English proficiency caregivers. Clin Pediatr. 2019;58(2):247–9.

    Article  Google Scholar 

  27. Panayiotou A, Gardner A, Williams S, Zucchi E, Mascitti-Meuter M, Goh AM, et al. Language translation apps in health care settings: expert opinion. JMIR Mhealth Uhealth. 2019;7(4):e11316.

    Article  Google Scholar 

  28. Patil S, Davies P. Use of Google translate in medical communication: evaluation of accuracy. BMJ. 2014;349:g7392.

    Article  Google Scholar 

  29. Office for Civil Rights (OCR), Office of the Secretary, United States Department of Health and Human Services. Proposed rule: nondiscrimination in health and health education programs or activities (84 FR 27846), RIN 0945-AA11; 2019.

  30. Wang BB, Wan TTH, Burke DE, Bazzoli GJ, Lin BYJ. Factors influencing health information system adoption in American hospitals. Health Care Manage Rev. 2005;30(1):44–51.

    Article  Google Scholar 

  31. López L, Rodriguez F, Huerta D, Soukup J, Hicks L. Use of interpreters by physicians for hospitalized limited English proficient patients and its impact on patient outcomes. J Gen Intern Med. 2015;30(6):783–9.

    Article  Google Scholar 

  32. Taira BR. Improving communication with patients with limited English proficiency. JAMA Intern Med. 2018;178(5):605–6.

    Article  Google Scholar 

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Acknowledgements

Authors would like to acknowledge Kylie Glover for her assistance with data collection for this study. This project was funded in part by a Grant from the Health Equity Research Center, a strategic research initiative of Washington State University.

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Authors and Affiliations

  1. College of Nursing, Washington State University, 412 E. Spokane Falls Blvd, Spokane, WA, 99201, USA

    Janessa M. Graves & Lilian Nguyen

  2. Harborview Injury Prevention and Research Center (HIPRC), Seattle, WA, USA

    Janessa M. Graves, Megan Moore & Monica S. Vavilala

  3. Language Access Research for Community Health (LARCH) Coalition, Seattle, WA, USA

    Janessa M. Graves, Megan Moore, Carmen Gonzalez, Joana Ramos & Monica S. Vavilala

  4. School of Social Work, University of Washington, Seattle, WA, USA

    Megan Moore

  5. Department of Communication, University of Washington, Seattle, WA, USA

    Carmen Gonzalez

  6. Washington State Coalition for Language Access (WASCLA), Seattle, WA, USA

    Joana Ramos

  7. Department of Anesthesiology and Pain Medicine, School of Medicine, University of Washington, Seattle, WA, USA

    Monica S. Vavilala

  8. Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA

    Monica S. Vavilala

Authors
  1. Janessa M. Graves
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  2. Megan Moore
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  5. Lilian Nguyen
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Correspondence to Janessa M. Graves.

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Graves, J.M., Moore, M., Gonzalez, C. et al. Too Little Information: Accessibility of Information About Language Services on Hospital Websites. J Immigrant Minority Health 22, 433–438 (2020). https://doi.org/10.1007/s10903-020-00978-8

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  • DOI: https://doi.org/10.1007/s10903-020-00978-8

Keywords

  • Hospital
  • Internet
  • Language
  • Access
  • Equity
  • Website