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. 2013 Dec 28:13:535.
doi: 10.1186/1472-6963-13-535.

Potential for patient-physician language discordance in Ontario

Jennifer Sears  1 , Kamran Khan, Chris I Ardern, Hala Tamim
Affiliations

Potential for patient-physician language discordance in Ontario

Jennifer Sears et al. BMC Health Serv Res. .

Abstract

Background: Patient-Physician language discordance occurs when the patient and physician lack proficiency in the same language(s). Previous literature suggests language discordant clinical encounters compromise patient quality of care and health outcomes. The objective of this study was to quantify and visualize the linguistic and spatial mismatch between Ontario's population not proficient in English or French but proficient in one of the top five non-official languages and the physicians who are proficient in the same non-official language.

Methods: Using data from the 2006 Canadian census and the 2006 Canadian Medical Directory, we determined the number of non-English/non-French (NENF) speaking individuals and the number of Ontario physicians proficient in the top five non-official languages in each census division (CD) of Ontario. For each non-official language, we produced bi-variate choropleth maps of Ontario, broken down into the 49 CDs, to determine which CDs had the highest risk of language discordant clinical encounters.

Results: According to the 2006 Canadian census, the top five non-official languages spoken by Ontario's NENF population were: Chinese, Italian, Punjabi, Portuguese and Spanish. For each of the top five non-official languages, there were at least 5 census divisions with a NENF population speaking a non-official language without any primary care physicians proficient in that non-official language. The size of NENF populations within these CDs ranged from 10 individuals to 1,470 individuals.

Conclusions: Understanding the linguistic capabilities of Ontario's immigrant population & the linguistic capabilities of Ontario's primary care physicians is essential to ensure equal access and quality of healthcare. As immigration continues to increase, we may find that the linguistic needs of Ontario's immigrant population diverge from the linguistic capabilities of Ontario's primary care physicians. Further research on the language discordance in Ontario is needed in order to reduce the risk of language discordant clinical encounters and the negative health outcomes associated with these encounters.

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Figures

Figure 1
Figure 1
The distribution of languages spoken by the Ontario population in 2006.
Figure 2
Figure 2
A map of Ontario broken down into 49 census divisions as defined by Statistics Canada in 2006.
Figure 3
Figure 3
A map of the number of NENF Chinese speaking individuals and the number of primary care physicians proficient in Chinese per census division in Ontario in 2006.
Figure 4
Figure 4
A map of the number of NENF Italian speaking individuals and the number of primary care physicians proficient in Italian per census division in Ontario in 2006.
Figure 5
Figure 5
A map of the number of NENF Punjabi speaking individuals and the number of primary care physicians proficient in Punjabi per census division in Ontario in 2006.
Figure 6
Figure 6
A map of the number of NENF Portuguese speaking individuals and the number of primary care physicians proficient in Portuguese per census division in Ontario in 2006.
Figure 7
Figure 7
A map of the number of NENF Spanish speaking individuals and the number of primary care physicians proficient in Spanish per census division in Ontario in 2006.
See this image and copyright information in PMC

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