Changes in Language Services Use by US Pediatricians

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Language barriers adversely affect health care access, utilization, outcomes, and patient safety. Trained formal interpreters can improve care quality and safety, but many patients and families with limited English proficiency do not receive appropriate language services during health care encounters.WHAT THIS STUDY ADDS: Despite continued growth of the US population with limited English proficiency, federal language use standards, and enhanced education about appropriate use of language services, there has been only modest improvement over time in pediatricians' use of language services. RESULTS: Most pediatricians reported using family members to communicate with LEP patients and families, but there was a decrease from 2004 to 2010 (69.6%, 57.1%, P , .01). A higher percentage of pediatricians reported formal interpreter use (professional and/or telephone) in 2010 (55.8%) than in 2004 (49.7%, P , .05); the increase was primarily attributable to increased telephone interpreter use (28.2%, 37.8%, P , .01). Pediatricians in states with reimbursement had twice the odds of formal interpreter use versus those in nonreimbursing states (odds ratio 2.34; 95% confidence interval 1.24-4.40).CONCLUSIONS: US pediatricians' use of appropriate language services has only modestly improved since 2004. Expanding language services reimbursement may increase formal interpreter use. Pediatrics 2013;132:e396-e406 AUTHORS:

Racial and Ethnic Disparities in Healthcare-Associated Infections in the United States, 2009–2011

“…Although the use of a professional interpreter is recommended whenever communicating with patients with limited English proficiency, this recommendation is frequently not adhered to. 25 Our findings, therefore, provide a potential opportunity for improving HAI rates that has previously received little attention.…”

Availability of Outpatient Rehabilitation Services for Children After Traumatic Brain Injury

“…Despite regulatory requirements that health care settings provide access to language services at no cost, 30,31 recent studies of pediatricians demonstrate that many report routinely using non-professional interpreters such as family members. 9, 32-35 Evidence-based standardization of care transitions from acute care to outpatient rehabilitation for moderate to severely injured children with TBI will be important to address service inequalities. Understanding cultural needs and potential barriers to service access are also important next steps.…”

Evaluation of a Quality Improvement Intervention to Increase Use of Telephonic Interpretation

“…[8][9][10][11] Both in-person and telephonic professional medical interpretation effectively mitigate the risks associated with language barriers, [12][13][14] but underutilization of professional interpreters is widespread. [15][16][17][18][19] Many providers choose to "get by" with nonproficient language skills, 20 Dr Lion conceptualized and designed the study, performed the analyses, and drafted the manuscript; Dr Ebel assisted with study design, participated in analysis planning and interpretation, and reviewed and critically revised the manuscript; Ms Rafton and Ms Hencz contributed to study design and reviewed and provided critical input on the manuscript; Dr Zhou provided critical input on study design and analysis, and reviewed and revised the manuscript; Dr Mangione-Smith participated in study design, contributed to analytic planning and interpretation of results, and critically revised the manuscript; and all authors approved the final manuscript as submitted. Accepted for publication Sep 23, 2014 saw families with LEP reported using no professional interpretation.…”

“…Accepted for publication Sep 23, 2014 saw families with LEP reported using no professional interpretation. 15 The reasons for underuse are multifactorial and, at the system level, involve organizational culture, lack of investment in interpretation, inconsistent identification of language need, and inadequate clinician training. 21,22 At the encounter level, provider decision-making includes considerations of their own and the patient's or family's language proficiency, convenience, and the expected complexity of the clinical encounter.…”