Association between language proficiency and the quality of primary care among a national sample of insured Latinos.
BACKGROUND
Latinos experience substantial barriers to primary care. Limited English language proficiency may be a mechanism for these deficiencies, even for Latinos with health coverage.


OBJECTIVE
To determine the relationship between English language proficiency and the experience of primary care reported by insured Latinos.


METHODS
Analysis of the National Latino and Asian American Study, a nationally representative household survey, 2002-2003. This analysis was restricted to Latinos who reported current health insurance (n= 1792), and included information on ethnic subgroups.


METHODS
Four outcomes addressed different aspects of the quality of primary care: (1) not having a regular source of care or lacking continuity of care, (2) difficulty getting an appointment over the phone, (3) long waits in the waiting room, and (4) difficulty getting information or advice by phone.


RESULTS
English language proficiency was associated with the experience of primary care for 3 of the 4 outcomes. Insured Latinos with poor/fair English language proficiency were more likely than those with good/excellent proficiency to report not having a regular source of care or lacking continuity [odds ratio (OR) 2.20, 95% confidence interval (CI) 1.60-3.02], long waits (OR, 1.88; CI, 1.34-2.64), and difficulty getting information/advice by phone (OR, 1.76; 95% CI, 1.25-2.46).


CONCLUSIONS
Among insured Latinos, low English language proficiency is associated with worse reports of the quality of primary care. These results suggest that interventions to address limited English proficiency may be important to improving the quality of primary care for this rapidly growing population.
Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, 1620 Tremont Street, Boston, MA 02120, USA.
Jennifer R
JR
Pippins
Margarita
M
Alegría
Jennifer S
JS
Haas
D000293:Adolescent; D000328:Adult; D000368:Aged; D003142:Communication; D003266:Continuity of Patient Care; D004522:Educational Status; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006630:Hispanic or Latino; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D007802:Language; D008297:Male; D017533:Marital Status; D008605:Mental Health Services / Q000458:organization & administration; D008875:Middle Aged; D011320:Primary Health Care / Q000458:organization & administration*; D011787:Quality of Health Care; D014850:Waiting Lists