Mount Sinai Journal of Medicine - Volume 65, Number 5&6, Page 393

Volume 65 Number 5&6
October/November 1998 back to contents

The Impact of Language as a Barrier to Effective Health Care 393

in an Underserved Urban Hispanic Community Rand A. David, M.D., And Michelle Rhee, B.A.

From the Division of General Medicine, Department of Medicine, Mount Sinai School of Medicine, New York, NY.

Address correspondence to Rand A. David, M.D., Director, Ambulatory Care, Elmhurst Hospital Center, 79-01 Broadway, Room D1-24, Elmhurst, NY 11373.

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.

KEY WORDS
Doctor-patient relationship, Hispanic, language, non-English speaking, patient satisfaction

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Volume 65 Number 5&6 October/November 1998	back to contents

The Impact of Language as a Barrier to Effective Health Care	393
in an Underserved Urban Hispanic Community Rand A. David, M.D., And Michelle Rhee, B.A.
From the Division of General Medicine, Department of Medicine, Mount Sinai School of Medicine, New York, NY. Address correspondence to Rand A. David, M.D., Director, Ambulatory Care, Elmhurst Hospital Center, 79-01 Broadway, Room D1-24, Elmhurst, NY 11373.