Studies Examine Quality Of Care For Patients With Limited-English Proficiency

Main Category: Public Health
Also Included In: Primary Care / General Practice
Article Date: 22 Nov 2007 - 9:00 PDT

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Several studies published in a special supplement of the Journal of General Internal Medicine report examined various disparities in quality of care between people with limited-English proficiency and those who speak English, HealthDay/Washington Post reports. According to a news release on the supplement, an estimated 20 million people in the U.S., or one in 15, speak little to no English.

In one study, led by Yael Schenker of the University of California-San Francisco, researchers found that 53% of English-speaking patients who were set to undergo invasive procedures had signed consent forms in their medical records, compared with 28% of LEP patients. In addition, 85% of the medical records of English-speaking patients contained a signed consent form in any language, compared with 70% of LEP patients, which suggests that there are differences in both practice and documentation of medical staff, researchers said. Schenker said, "Informed consent is a fundamental tenet of the U.S. health care system. While language barriers make obtaining informed consent more complex, it is still a legal and ethical requirement and is increasingly recognized as a key component of quality care and patient safety. Hospitals must work harder to break down the language barriers faced by LEP patients."

A second study, led by researcher Eric Cheng of the VA Greater Los Angeles Healthcare System, found that 35% of Hispanics who do not speak English at home receive 10 recommended health care services, compared with 57% of white, English-speaking patients. A third study, led by Maria Moreno of Sutter Health in Northern California examined the language skills of "dual-role" health staff members, or those who might be asked to serve as an interpreter but whose primary responsibilities are in another area. According to the study, 2% of such staff members failed a competency test and 21% had limited reading, writing and speaking capabilities in two languages. Researchers also found errors in interpretation services, such as word omissions and confusion, that could lead to medical errors.

Moreno said, "With the absence of guidelines and a 'formal certification' process to demonstrate interpreter competence, many health care facilities across the country may not be providing the best possible care to all patients." Cheng added, "Clearly, language usage predicts the quality of clinical care that patients receive" (HealthDay/Washington Post, 11/19).

The supplement is available online.

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