Experiences of Latinos with limited English proficiency with patient registration systems and their interactions with clinic front office staff: an exploratory study to inform community-based translational research in North Carolina

Abstract

BackgroundHealth services research of Latinos with limited English proficiency (LEP) have largely focused on studying disparities related to patient-provider communication. Less is known about their non-provider interactions such as those with patient registration systems and clinic front office staff; these interactions precede the encounter with providers and may shape how comfortable patients feel about their overall health services experience. This study explored Latino patients with LEP experiences with, and expectations for, interactions with patient registration systems and front office staff.MethodsWe conducted 20 in-depth interviews with Latinos with LEP (≥18 years of age) who seek health services in the Piedmont Triad region, North Carolina. We analyzed participants’ quotes and identified themes by using a constant comparison method. This research was conducted by a community-academic partnership; partners were engaged in study design, instrument development, recruitment, data analysis, and manuscript writing.ResultsQualitative analysis allowed us to identify the following recurring themes: 1) inconsistent registration of multiple surnames may contribute to patient misidentification errors and delays in receiving health care; 2) lack of Spanish language services in front office medical settings negatively affect care coordination and satisfaction with health care; and 3) perceived discrimination generates patients’ mistrust in front office staff and discomfort with services.ConclusionLatino patients in North Carolina experience health services barriers unique to their LEP background. Participants identified ways in which the lack of cultural and linguistic competence of front office staff negatively affect their experiences seeking health services. Healthcare organizations need to support their staff to encourage patient-centered principles.

Medical mistrust as a key mediator in the association between perceived discrimination and adherence to antiretroviral therapy among HIV-positive Latino men

“…Consistent with other studies (Calo et al, 2015; LaVeist et al, 2000), medical mistrust was found in the present study to be significantly associated with perceived discrimination. However, this occurred only with the discrimination variables for Latino ethnicity and HIV serostatus.…”

“…In addition, medical mistrust was found to mediate the associations between both Latino ethnicity discrimination and HIV serostatus discrimination and adherence to ART. Medical mistrust may be of particular concern for Latino populations whose limited English proficiency and undocumented status make them vulnerable to negative encounters with health care staff, resulting in their discomfort with the health care system (Calo et al, 2015). …”

“…For example, among Latinos with limited English proficiency, perceived discrimination from medical clinic front office staff is associated with mistrust of the staff and discomfort with health services (Calo et al, 2015). Medical mistrust is also associated with negative health behaviors.…”

US Healthcare Experiences of Hispanic Patients with Diabetes and Family Members: A Qualitative Analysis

“…Lower feelings of discrimination have been reported by Hispanics when they have perceived healthcare providers to be respectful and sensitive to their culture (Becerra, Androff, Messing, Castillo, & Cimino, 2015; Nápoles et al, 2012). Greater patient satisfaction and trust have been reported when patients perceive they have been treated respectfully by the healthcare community regardless of insurance status, English language proficiency, or race/ethnicity (Becerra et al, 2015; Calo et al, 2015; Tajeu et al, 2015). …”

“…Further, they have higher rates of limited English proficiency, lack health insurance, achieve lower educational attainment, and experience lower annual household income than non-Hispanic Whites (North Carolina Department of Health and Human Services Division of Public Health & State Center for Health Statistics, 2015, November; Pew Research Center, 2014). Hispanics in North Carolina may encounter greater language obstacles when seeking healthcare such as fewer available trained interpreters and less bilingual healthcare providers, which can impact quality of care and lead to long wait times and patient dissatisfaction (Calo et al, 2015). The information learned from this study may be useful in influencing chronic disease management, healthcare providers, and organizational policies.…”