Language Services In Hospitals Vary By Ownership And Location

Schiaffino, Melody K.; Nara, Atsushi; Mao, Liang

doi:10.1377/hlthaff.2015.0955

Cited by 59 publications

(41 citation statements)

References 3 publications

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“…28,30–33 A recent study found only 68.8% of hospitals in the United States offered language services, including only 74.7% of hospitals characterized as having a high level of need for language services. 34 The cost of hiring interpreters may be considered prohibitive by some health care organizations; however, studies indicate that the estimated cost of providing interpreter services is relatively modest compared with the overall cost of health care and potential benefits, ranging from $4 to $279 per person per year. 35–38 Unfortunately, even when interpreters are readily available, they are underused.…”

Section: Discussionmentioning

confidence: 99%

Communication With Limited English-Proficient Families in the PICU

Zurca¹,

Fisher²,

Flor

et al. 2017

Hospital Pediatrics

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OBJECTIVE Health care disparities have been described for children of limited English-proficient (LEP) families compared with children of English-proficient (EP) families. Poor communication with the medical team may contribute to these worse health outcomes. Previous studies exploring communication in the PICU have excluded LEP families. We aimed to understand communication experiences and preferences in the 3 primary communication settings in the PICU. We also explored LEP families’ views on interpreter use in the PICU. PATIENTS AND METHODS EP and Spanish-speaking LEP families of children admitted to the PICU of a large tertiary pediatric hospital completed surveys between 24 hours and 7 days of admission. RESULTS A total of 161 of 184 families were surveyed (88% response rate); 52 were LEP and 109 EP. LEP families were less likely to understand the material discussed on rounds (odds ratio [OR] 0.32, 95% confidence interval [CI] 0.11–0.90), to report that PICU nurses spent enough time speaking with them (OR 0.15, 95% CI 0.05–0.41), and to report they could rely on their nurses for medical updates (OR 0.07, 95% CI 0.02–0.25) controlling for covariates, such as education, insurance type, presence of a chronic condition, PICU length of stay, and mortality index. LEP families reported 53% of physicians and 41% of nurses used an interpreter “often.” CONCLUSIONS Physician and nurse communication with LEP families is suboptimal. Communication with LEP families may be improved with regular use of interpreters and an increased awareness of the added barrier of language proficiency.

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Section: Discussionmentioning

confidence: 99%

Communication With Limited English-Proficient Families in the PICU

Zurca¹,

Fisher²,

Flor

et al. 2017

Hospital Pediatrics

View full text Add to dashboard Cite

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“…It is estimated that 24 million people in the United States have limited English proficiency (LEP) [1]. These individuals may have difficulty communicating with health care providers resulting in compromised patient safety and overall poorer health outcomes [1–5].…”

Section: Introductionmentioning

confidence: 99%

“…These individuals may have difficulty communicating with health care providers resulting in compromised patient safety and overall poorer health outcomes [1–5]. However, assistance from professional interpreters has been shown to improve health care outcomes and satisfaction among LEP patients [4, 5].…”

Section: Introductionmentioning

confidence: 99%

“…More recently, the final rules released on language services under the Section 1557 of the Affordable Care Act of 2010 by the Department of Health and Human Services Office of Civil Rights strengthens and clarifies the obligations required to not only provide language services but also to ensure that they are meaningful [1, 6]. In addition, many states now require some form of language assistance for LEP patients [7].…”

Section: Introductionmentioning

confidence: 99%

“…Despite federal and state mandates, a significant number of hospitals and clinics have still not taken appropriate measures to help ensure adequate communication of health related matters to LEP patients [1, 7, 10]. While the CLAS Standards are not statutory or regulatory requirements per se, failure by hospitals to provide adequate language services to LEP patients has resulted in investigations for violations of Title VI of the Civil Rights Act of 1964 [7, 8, 10].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of the efficiency of language interpreter services in a busy surgical and procedural practice

Burkle

Anderson

Xiong

et al. 2017

BMC Health Serv Res

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BackgroundSurgical and procedural patient care settings require efficient patient flow. The primary goal of this study was to assess use and efficiency of language services for our limited English proficiency (LEP) patients undergoing surgical and outpatient procedures.MethodsPatient language services needs were recorded from our operating room and procedural locations over a two and a half month period in 2016. Time from in-person interpreter request to arrival was recorded. Frequency of language service modality used and reason for telephone and professional video remote interpreting (VRI) rather than in person professional services was queried.ResultsMean time from in-person interpreter request until arrival was 19 min. Variation was high. No cases were cancelled due to lack of available interpretive services and no LEP patient underwent a procedure without requested interpretative service assistance.ConclusionsTime for in person professional interpreter assistance was short but highly variable. Access to telephone interpretive services and VRI services ensured assistance when in person interpreters were immediately unavailable.With the numbers of LEP patients increasing over time along with any new mandates for providing language assistance, the stress on hospital patient service units and the financial implications for many health care facilities will likely continue as challenges.

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Trial Participation and Outcomes Among English-Speaking and Spanish-Speaking Patients With Appendicitis Randomized to Antibiotics

Serrano,

Voldal,

Machado-Aranda

et al. 2023

JAMA Surg

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ImportanceSpanish-speaking participants are underrepresented in clinical trials, limiting study generalizability and contributing to ongoing health inequity. The Comparison of Outcomes of Antibiotic Drugs and Appendectomy (CODA) trial intentionally included Spanish-speaking participants.ObjectiveTo describe trial participation and compare clinical and patient-reported outcomes among Spanish-speaking and English-speaking participants with acute appendicitis randomized to antibiotics.Design, Setting, and ParticipantsThis study is a secondary analysis of the CODA trial, a pragmatic randomized trial comparing antibiotic therapy with appendectomy in adult patients with imaging-confirmed appendicitis enrolled at 25 centers across the US from May 1, 2016, to February 28, 2020. The trial was conducted in English and Spanish. All 776 participants randomized to antibiotics are included in this analysis. The data were analyzed from November 15, 2021, through August 24, 2022.InterventionRandomization to a 10-day course of antibiotics or appendectomy.Main Outcomes and MeasuresTrial participation, European Quality of Life–5 Dimensions (EQ-5D) questionnaire scores (higher scores indicating a better health status), rate of appendectomy, treatment satisfaction, decisional regret, and days of work missed. Outcomes are also reported for a subset of participants that were recruited from the 5 sites with a large proportion of Spanish-speaking participants.ResultsAmong eligible patients 476 of 1050 Spanish speakers (45%) and 1076 of 3982 of English speakers (27%) consented, comprising the 1552 participants who underwent 1:1 randomization (mean age, 38.0 years; 976 male [63%]). Of the 776 participants randomized to antibiotics, 238 were Spanish speaking (31%). Among Spanish speakers randomized to antibiotics, the rate of appendectomy was 22% (95% CI, 17%-28%) at 30 days and 45% (95% CI, 38%-52%) at 1 year, while in English speakers, these rates were 20% (95% CI, 16%-23%) at 30 days and 42% (95% CI 38%-47%) at 1 year. Mean EQ-5D scores were 0.93 (95% CI, 0.92-0.95) among Spanish speakers and 0.92 (95% CI, 0.91-0.93) among English speakers. Symptom resolution at 30 days was reported by 68% (95% CI, 61%-74%) of Spanish speakers and 69% (95% CI, 64%-73%) of English speakers. Spanish speakers missed 6.69 (95% CI, 5.51-7.87) days of work on average, while English speakers missed 3.76 (95% CI, 3.20-4.32) days. Presentation to the emergency department or urgent care, hospitalization, treatment dissatisfaction, and decisional regret were low for both groups.Conclusions and RelevanceA high proportion of Spanish speakers participated in the CODA trial. Clinical and most patient-reported outcomes were similar for English- and Spanish-speaking participants treated with antibiotics. Spanish speakers reported more days of missed work.Trial RegistrationClinicalTrials.gov Identifier: NCT02800785

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Language Services In Hospitals Vary By Ownership And Location

Cited by 59 publications

References 3 publications

Communication With Limited English-Proficient Families in the PICU

Communication With Limited English-Proficient Families in the PICU

Assessment of the efficiency of language interpreter services in a busy surgical and procedural practice

Trial Participation and Outcomes Among English-Speaking and Spanish-Speaking Patients With Appendicitis Randomized to Antibiotics

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