Language Barriers to Health Care in the United States

Flores, Glenn

doi:10.1056/nejmp058316

Cited by 418 publications

(306 citation statements)

References 4 publications

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“…Language barriers encountered in the care of patients with limited English proficiency (LEP), a growing segment of the U.S. population 2 , adversely affect healthcare quality. Patients with LEP may have decreased access to acute care and preventive services [3][4][5][6] , decreased satisfaction with care 7,8 , poor understanding of instructions or medications 9,10 , longer hospital stays 11 , and an increased risk of medical errors and misdiagnoses [12][13][14][15][16] .…”

Section: Introductionmentioning

confidence: 99%

Getting By: Underuse of Interpreters by Resident Physicians

et al. 2008

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BACKGROUND: Language barriers complicate physicianpatient communication and adversely affect healthcare quality. Research suggests that physicians underuse interpreters despite evidence of benefits and even when services are readily available. The reasons underlying the underuse of interpreters are poorly understood. OBJECTIVE:To understand the decision-making process of resident physicians when communicating with patients with limited English proficiency (LEP). DESIGN:Qualitative study using in-depth interviews. PARTICIPANTS:Internal medicine resident physicians (n=20) from two urban teaching hospitals with excellent interpreter services.APPROACH: An interview guide was used to explore decision making about interpreter use.RESULTS: Four recurrent themes emerged: 1) Resident physicians recognized that they underused professional interpreters, and described this phenomenon as "getting by;" 2) Resident physicians made decisions about interpreter use by weighing the perceived value of communication in clinical decision making against their own time constraints; 3) The decision to call an interpreter could be preempted by the convenience of using family members or the resident physician's use of his/her own second language skills; 4) Resident physicians normalized the underuse of professional interpreters, despite recognition that patients with LEP are not receiving equal care. CONCLUSIONS:Although previous research has identified time constraints and lack of availability of interpreters as reasons for their underuse, our data suggest that the reasons are far more complex. Residents at the study institutions with interpreters readily available found it easier to "get by" without an interpreter, despite misgivings about negative implications for quality of care. Findings suggest that increasing interpreter use will require interventions targeted at both individual physicians and the practice environment.KEY WORDS: communication; doctor-patient relationships; physician behavior; decision making; qualitative research.

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Section: Introductionmentioning

confidence: 99%

Getting By: Underuse of Interpreters by Resident Physicians

et al. 2008

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“…Religious aspects, gender attitudes and health beliefs were found to alter communication between health care providers and patient in ER (Taylor et al, 2013). Vocal-medical: on-line language learning and cultural preparation... DOI: http://dx.doi.org/10.12795/elia.2015.i15.08 Several studies in the last decades emphasize the need to bridge the language gap and intercultural barriers in emergency care (Meischke et al, 2013;Flores, 2006;Carrasquillio et al, 1999). Research shows significant effects on 'time to dispatch' (for example, delay in start-up of resuscitation), accuracy of the level of medical care delivery, misinterpretation of symptoms and diagnostic mistakes, and overall satisfaction of non-native speaking patients in ER (Brach et al, 2005;Quan, 2010).…”

Section: Rationale -Research Summarymentioning

confidence: 99%

Vocal-Medical: On-Line Language Learning and Cultural Preparation for Emergency Services

Brogan¹,

Adriaenssens²,

Kelly³

2015

Elia

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“…Healthcare providers' decisions may result in allocating more resources to some individuals than to others (Fiske, 1998). Bureaucratic systems including HMOs, managed care organizations, and public insurers (for example, Medicare and Medicaid) have disrupted traditional community-based care with providers who are familiar with the language (Flores, 2006) and culture of ethnic minority communities (Larrison, VelezOrtiz, Hernandez, Piedra, & Goldberg, 2010;Leigh, Lillie-Blanton, Martinez, & Collins, 1999).…”

Section: What Are Health Disparities and Why Do They Exist?mentioning

confidence: 99%

Health Disparities: A Primer for Public Health Social Workers

Keefe

2010

Social Work in Public Health

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Language Barriers to Health Care in the United States

Cited by 418 publications

References 4 publications

Getting By: Underuse of Interpreters by Resident Physicians

Getting By: Underuse of Interpreters by Resident Physicians

Vocal-Medical: On-Line Language Learning and Cultural Preparation for Emergency Services

Health Disparities: A Primer for Public Health Social Workers

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