Examining Quality Of Health Care For Patients With Limited-English Proficiency

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Several studies published in a special supplement of the Journal of General Internal Medicinereport examined various disparities in quality of care between peoplewith limited-English proficiency and those who speak English, HealthDay/Washington Postreports. According to a news release on the supplement, an estimated 20million people in the U.S., or one in 15, speak little to no English.

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In one study, led by Yael Schenker of the University of California-San Francisco,researchers found that 53% of English-speaking patients who were set toundergo invasive procedures had signed consent forms in their medicalrecords, compared with 28% of LEP patients. In addition, 85% of themedical records of English-speaking patients contained a signed consentform in any language, compared with 70% of LEP patients, which suggeststhat there are differences in both practice and documentation ofmedical staff, researchers said. Schenker said, "Informed consent is afundamental tenet of the U.S. health care system. While languagebarriers make obtaining informed consent more complex, it is still alegal and ethical requirement and is increasingly recognized as a keycomponent of quality care and patient safety. Hospitals must workharder to break down the language barriers faced by LEP patients."

A second study, led by researcher Eric Cheng of the VA Greater Los Angeles Healthcare System,found that 35% of Hispanics who do not speak English at home receive 10recommended health care services, compared with 57% of white,English-speaking patients. A third study, led by Maria Moreno of Sutter Healthin Northern California examined the language skills of "dual-role"health staff members, or those who might be asked to serve as aninterpreter but whose primary responsibilities are in another area.According to the study, 2% of such staff members failed a competencytest and 21% had limited reading, writing and speaking capabilities intwo languages. Researchers also found errors in interpretationservices, such as word omissions and confusion, that could lead tomedical errors.

Moreno said, "With the absence of guidelinesand a 'formal certification' process to demonstrate interpretercompetence, many health care facilities across the country may not beproviding the best possible care to all patients." Cheng added,"Clearly, language usage predicts the quality of clinical care thatpatients receive" (HealthDay/Washington Post, 11/19).

Reprinted with permission from kaisernetwork.org. You can view theentire Kaiser WeeklyHealth Disparities Report,search the archives, and sign up for email delivery at kaisernetwork.org/email. The Kaiser Weekly HealthDisparities Report is published for kaisernetwork.org, a free service of TheHenry J. Kaiser Family Foundation.

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