Health Care Quality Perceptions among Foreign-Born Latinos and the Importance of Speaking the Same Language

Abstract

Objectives: To examine the relationship between patients' English proficiency, patient-provider language concordance, and health care quality among foreign-born Latinos in the United States.Methods: National probability sample data (from the Pew Hispanic Center/Robert Wood Johnson Foundation Latino Health Survey) were analyzed from telephone interviews with foreign-born Latino adults (n ‫؍‬ 2921; aged 18 years and older). There were 3 main outcomes related to clinical experiences using self-reports of confusion, frustration, and perception of poor quality of care received because of English-speaking ability and accent bias, as well as an overall rating of care quality. Patients' English proficiency and patient-provider language concordance were the chief predictors.Results: Patients' English proficiency was not significantly associated with the 3 clinical experiences measures and marginally so with overall care quality ratings. Language concordance was significantly associated with a lower likelihood of confusion, frustration, and language-related poor quality ratings, and was positively associated with patient-reported overall quality of care. In addition, providers' language concordance attenuated the statistical significance of the effects of patients' English proficiency when both were modeled simultaneously. Latinos, who now comprise more than 15% of the United States population, are the largest and fastest growing ethnic/racial group. The US Census projects that by the year 2050 approximately one third of the US population will be Latino. As this population continues to grow at rates that exceed most previous estimates, demand for goods and services that meet the needs of Latinos will continue to influence market trends in the United States, including health care. With half of Latinos not speaking English "very well," quality health care will be achieved through meeting the language needs of Latino "consumers." Indeed, the Institute of Medicine and the Agency for Health Care Research and Quality have identified removing language barriers as essential to reducing ethnic/racial health care disparities.3,4 As such, understanding the relationship between language and health care quality has important public health implications for providing services in an increasingly diverse US population.Highly sensitive diagnostic tests continue to improve medical practice science; however, clinical interviews by skillful health care providers will always This article was externally peer reviewed.

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