Disparities/Minority Health

Interpreters are an effective communication option for patients with limited English proficiency

Nearly one in five U.S. residents speaks a language other than English at home. Individuals with limited English proficiency (LEP) have more difficulty communicating with health care providers and are less satisfied with their care than others. According to a study supported in part by the Agency for Healthcare Research and Quality (HS10316), patients with LEP who have an interpreter available during their visit rate communication and satisfaction with care similar to those patients with language concordant providers.

Researchers surveyed 2,715 LEP Chinese and Vietnamese immigrant adults, who received care at 11 community-based health centers across the U.S., to explore their perceptions of care. Nearly all of them (94 percent) spoke English "not well" or "not at all"; 63 percent had 9 or fewer years of education; and 51 percent reported "fair" or "poor" health. Use of interpreters at the health centers ranged from 18 to 89 percent. Patients who used interpreters did not differ significantly in their responses on three communication measures from patients whose doctors spoke their language. Measures included how often clinicians provided explanations they could understand, whether they received as much information about their health and treatment as they wanted, and whether they had sufficient time to explain the reason for their visits.

Also, about half of both groups rated the health care they received as excellent or very good. However, more LEP Asian immigrants who used interpreters than those with language-concordant doctors reported having questions about their care (30 vs. 21 percent) or about their mental health (25 vs. 18 percent) that they wanted to ask, but did not. Overall, 57 percent of those with interpreters rated them as excellent or very good, while 43 percent gave lower ratings (good, fair, or poor). Patients who rated their interpreters highly were nearly 5 times more likely to highly rate the health care they received at the visit.

See "Interpreter services, language concordance, and health care quality: Experiences of Asian Americans with limited English proficiency," by Alexander R. Green, M.D., M.P.H., Quyen Ngo-Metzger, M.D., M.P.H., Anna T. Legedza, Sc.D., and others, in the November 2005 Journal of General Internal Medicine 20, pp. 1050-1056.

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