alexa The impact of language as a barrier to effective health care in an underserved urban Hispanic community.


Journal of Clinical & Cellular Immunology

Author(s): David RA, Rhee M

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Abstract BACKGROUND: Language barriers between patient and physician impact upon effective health care. This phenomenon is not well studied in the literature. METHODS: A survey was created in English and Spanish, and administered at the ambulatory site for medical housestaff and faculty at a teaching hospital. "Cases" were defined as patients who reported using a translator or as having poor English skills. Patients who reported not using a translator and having good English skills served as controls. Both groups were predominantly of Hispanic origin. RESULTS: Analysis revealed 68 cases and 193 controls. The survey completion rate was 96\%. The data were predominantly categorical. Chi-square analysis was utilized. Both groups responded that understanding medication side effects corresponds to compliance (87\% cases vs 93\% controls, p = 0.18). More cases responded that side effects were not explained (47\% vs 16\%, p < 0.001). More controls reported satisfaction with medical care (93\% vs 84\%, p < 0.05). More controls agreed that their doctors understood how they were feeling, with statistical significance in Hispanic subset analysis (87\% vs 72\%, p < 0.05). Both groups felt they had enough time to communicate with their doctors (89\% vs 88\%, p = 0.86). More cases than controls reported having had a mammogram within the last 2 years (78\% vs 60\%, p < 0.05). CONCLUSIONS: Lack of explanation of side effects to medication appeared to correlate negatively with compliance with medication. The language barrier correlated negatively with patient satisfaction. Cases reported more preventive testing; test ordering may replace dialogue.
This article was published in Mt Sinai J Med and referenced in Journal of Clinical & Cellular Immunology

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