The impact of language as a barrier to effective health care in an underserved urban Hispanic community.
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.
David
R A
RA
Department of Medicine, Mount Sinai School of Medicine, New York, NY, USA.
Rhee
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003144:Communication Barriers; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011204:Poverty Areas; D014481:United States