The impact of language as a barrier to effective health care in an underserved urban Hispanic community

Abstract

Background: Language barriers between patient and physician impact upon effective health care. This phenomenon is not well studied in the literature.

Methods: A survey was created in English and Spanish, and administered at the ambulatory site for medical housestaff and faculty at a teaching hospital. "Cases" were defined as patients who reported using a translator or as having poor English skills. Patients who reported not using a translator and having good English skills served as controls. Both groups were predominantly of Hispanic origin.

Results: Analysis revealed 68 cases and 193 controls. The survey completion rate was 96%. The data were predominantly categorical. Chi-square analysis was utilized. Both groups responded that understanding medication side effects corresponds to compliance (87% cases vs 93% controls, p = 0.18). More cases responded that side effects were not explained (47% vs 16%, p < 0.001). More controls reported satisfaction with medical care (93% vs 84%, p < 0.05). More controls agreed that their doctors understood how they were feeling, with statistical significance in Hispanic subset analysis (87% vs 72%, p < 0.05). Both groups felt they had enough time to communicate with their doctors (89% vs 88%, p = 0.86). More cases than controls reported having had a mammogram within the last 2 years (78% vs 60%, p < 0.05).

Conclusions: Lack of explanation of side effects to medication appeared to correlate negatively with compliance with medication. The language barrier correlated negatively with patient satisfaction. Cases reported more preventive testing; test ordering may replace dialogue.