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. 2023 Feb 23;23(1):189.
doi: 10.1186/s12913-023-09176-2.

Patient dissatisfaction associated with physician-patient linguistic discordance in California clinics: an analytical cross-sectional study

Miguel A Fernández-Ortega  1 , Arturo Juárez-Flores  2 , Gustavo A Olaiz-Fernández  2 , Daniel A Muñiz-Salinas  2 ; AB1045 Law Analysis Group; Omar Rodríguez-Mendoza  2
Collaborators, Affiliations

Patient dissatisfaction associated with physician-patient linguistic discordance in California clinics: an analytical cross-sectional study

Miguel A Fernández-Ortega et al. BMC Health Serv Res. .

Abstract

Background: Patient satisfaction is considered as a product of two psychological processes, a cognitive one, including expectations and perceptions, and an emotional one resulting from the congruence between expectation and subjective perception of the user. The objective was to identify the factors associated with the level of perceived satisfaction in patients treated in 36 nonprofit health clinics that offer comprehensive health care services in four counties in the state of California, United States.

Methods: Cross-sectional analytical study in 14 clinics in four California counties. It consisted of the application of a 30-item questionnaire to determine the degree of patient satisfaction with the clinic. The factorial composition of the quality of care and clinic quality components was analyzed and two factors with an Eigen value greater than 1 were obtained.

Results: A total of 846 responses were registered. Factor analysis identified two underlying dimensions: Physician Attitude and Empathy. It was found that the discordance in language between the physician and the patient generates a difference in the perception of satisfaction. Patients who prefer to speak English have better satisfaction than those who speak Spanish. Spanish speakers who do not have interpreter have lower satisfaction than those who do (p < 0,01).

Conclusions: The most important sociodemographic cofactor was language. Satisfaction decreased in Spanish-speaking patients who were not proficient in the use of English since they expressed fewer comments and doubts.

Keywords: Communication barriers; Emigration and immigration; Health services accessibility; Language; Patient satisfaction; Primary health care.

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Conflict of interest statement

The authors declare that they have no competing interests” in this section.

The managers of the four participating clinics provided the facilities for the evaluation group to have the information available, support staff in the knowledge of community work and within the facilities. They did not participate in the design, data processing or writing of the manuscript.

Figures

Fig. 1
Fig. 1
Age and sex distribution of participants
Fig. 2
Fig. 2
Factor 1 comparison among counties (rural clinics)
Fig. 3
Fig. 3
Factor 2. Physician empathy perception by county (rural clinic)
Fig. 4
Fig. 4
Correlation between factors
See this image and copyright information in PMC

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