title: Interpreter services, language concordance, and health care quality. Experiences of Asian Americans with limited English proficiency.
abstract: BACKGROUND
  Patients with limited English proficiency (LEP) have more difficulty communicating with health care providers and are less satisfied with their care than others. Both interpreter- and language-concordant clinicians may help overcome these problems but few studies have compared these approaches.
  
  
  OBJECTIVE
  To compare self-reported communication and visit ratings for LEP Asian immigrants whose visits involve either a clinic interpreter or a clinician speaking their native language.
  
  
  METHODS
  Cross-sectional survey-response rate 74%.
  
  
  METHODS
  Two thousand seven hundred and fifteen LEP Chinese and Vietnamese immigrant adults who received care at 11 community-based health centers across the U.S.
  
  
  METHODS
  Five self-reported communication measures and overall rating of care.
  
  
  RESULTS
  Patients who used interpreters were more likely than language-concordant patients to report having questions about their care (30.1% vs 20.9%, P<.001) or about mental health (25.3% vs 18.2%, P=.005) they wanted to ask but did not. They did not differ significantly in their response to 3 other communication measures or their likelihood of rating the health care received as "excellent" or "very good" (51.7% vs 50.9%, P=.8). Patients who rated their interpreters highly ("excellent" or "very good") were more likely to rate the health care they received highly (adjusted odds ratio 4.8, 95% confidence interval, 2.3 to 10.1).
  
  
  CONCLUSIONS
  Assessments of communication and health care quality for outpatient visits are similar for LEP Asian immigrants who use interpreters and those whose clinicians speak their language. However, interpreter use may compromise certain aspects of communication. The perceived quality of the interpreter is strongly associated with patients' assessments of quality of care overall.
authors.affiliation: Institute for Health Policy, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. argreen@partners.org
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Green
authors.forename: Quyen
authors.initials: Q
authors.lastname: Ngo-Metzger
authors.forename: Anna T R
authors.initials: AT
authors.lastname: Legedza
authors.forename: Michael P
authors.initials: MP
authors.lastname: Massagli
authors.forename: Russell S
authors.initials: RS
authors.lastname: Phillips
authors.forename: Lisa I
authors.initials: LI
authors.lastname: Iezzoni
mesh_terms: D000328:Adult; D000368:Aged; D001213:Asian / Q000523:psychology; D002681:China / Q000208:ethnology; D003142:Communication; D003144:Communication Barriers; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D009819:Office Visits; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D014175:Translating; D014744:Vietnam / Q000208:ethnology