J Gen Intern Med. 2005 Nov;20(11):1050-6.



Interpreter services, language concordance, and health care quality.
Experiences of Asian Americans with limited English proficiency.



Green AR, Ngo-Metzger Q, Legedza AT, Massagli MP, Phillips RS, Iezzoni
LI.





Institute for Health Policy, Massachusetts General Hospital, Harvard
Medical School, Boston, MA 02114, USA. argreen@...



BACKGROUND: Patients with limited English proficiency (LEP) have more
difficulty communicating with health care providers and are less
satisfied with their care than others. Both interpreter- and
language-concordant clinicians may help overcome these problems but few
studies have compared these approaches.



OBJECTIVE: To compare self-reported communication and visit ratings for
LEP Asian immigrants whose visits involve either a clinic interpreter or
a clinician speaking their native language.



DESIGN: Cross-sectional survey-response rate 74%.



PATIENTS: Two thousand seven hundred and fifteen LEP Chinese and
Vietnamese immigrant adults who received care at 11 community-based
health centers across the U.S.



MEASUREMENTS: Five self-reported communication measures and overall
rating of care. RESULTS: Patients who used interpreters were more likely
than language-concordant patients to report having questions about their
care (30.1% vs 20.9%, P<.001) or about mental health (25.3% vs 18.2%,
P=.005) they wanted to ask but did not. They did not differ
significantly in their response to 3 other communication measures or
their likelihood of rating the health care received as "excellent" or
"very good" (51.7% vs 50.9%, P=.8). Patients who rated their
interpreters highly ("excellent" or "very good") were more likely to
rate the health care they received highly (adjusted odds ratio 4.8, 95%
confidence interval, 2.3 to 10.1).



CONCLUSIONS: Assessments of communication and health care quality for
outpatient visits are similar for LEP Asian immigrants who use
interpreters and those whose clinicians speak their language. However,
interpreter use may compromise certain aspects of communication. The
perceived quality of the interpreter is strongly associated with
patients' assessments of quality of care overall.















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