title: Changes in language services use by US pediatricians.
abstract: OBJECTIVE
  Access to appropriate language services is critical for ensuring patient safety and reducing the impact of language barriers. This study compared language services use by US pediatricians in 2004 and 2010 and examined variation in use in 2010 by pediatrician, practice, and state characteristics.
  
  
  METHODS
  We used data from 2 national surveys of pediatricians (2004: n = 698; 2010: n = 683). Analysis was limited to postresidency pediatricians with patients with limited English proficiency (LEP). Pediatricians reported use of ≥ 1 communication methods with LEP patients: bilingual family member, staff, physician, formal interpreter (professional, telephone), and primary-language written materials. Bivariate analyses examined 2004 to 2010 changes in methods used, and 2010 use by characteristics of pediatricians (age, sex, ethnicity), practices (type, location, patient demographics), and states (LEP population, Latino population growth, Medicaid/Children's Health Insurance Program language services reimbursement). Multivariate logistic regression was performed to determine adjusted odds of use of each method.
  
  
  RESULTS
  Most pediatricians reported using family members to communicate with LEP patients and families, but there was a decrease from 2004 to 2010 (69.6%, 57.1%, P < .01). A higher percentage of pediatricians reported formal interpreter use (professional and/or telephone) in 2010 (55.8%) than in 2004 (49.7%, P < .05); the increase was primarily attributable to increased telephone interpreter use (28.2%, 37.8%, P < .01). Pediatricians in states with reimbursement had twice the odds of formal interpreter use versus those in nonreimbursing states (odds ratio 2.34; 95% confidence interval 1.24-4.40).
  
  
  CONCLUSIONS
  US pediatricians' use of appropriate language services has only modestly improved since 2004. Expanding language services reimbursement may increase formal interpreter use.
authors.affiliation: Division of General Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. ldecamp1@jhmi.edu
authors.forename: Lisa Ross
authors.initials: LR
authors.lastname: DeCamp
authors.forename: Dennis Z
authors.initials: DZ
authors.lastname: Kuo
authors.forename: Glenn
authors.initials: G
authors.lastname: Flores
authors.forename: Karen
authors.initials: K
authors.lastname: O'Connor
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Minkovitz
mesh_terms: D000328:Adult; D002648:Child; D003144:Communication Barriers; D054521:Cultural Competency; D003625:Data Collection; D054242:Emigrants and Immigrants / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D005260:Female; D006301:Health Services Needs and Demand / Q000331:legislation & jurisprudence / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D061214:Patient Safety; D010372:Pediatrics / Q000331:legislation & jurisprudence / Q000639:trends*; D012051:Reimbursement Mechanisms / Q000331:legislation & jurisprudence / Q000639:trends; D013221:State Health Plans / Q000331:legislation & jurisprudence / Q000639:trends; D014175:Translating; D014481:United States; D014600:Utilization Review
keywords: Hispanic health care; health disparities; interpreters; language barriers; patient safety