title: The effects of language concordant care on patient satisfaction and clinical understanding for Hispanic pediatric surgery patients.
abstract: BACKGROUND
  Hispanics account for over 60% of the U.S. population growth and 25% speak little-to-no English. This language barrier adversely affects both access to and quality of care. Surgical specialties trail other medical fields in assessing the effects of language barriers to surgical clinical care and patient satisfaction. This study was designed to assess the effects of patient-provider language concordance on a pediatric surgery practice.
  
  
  METHODS
  A surgery-specific, 7-point Likert scale questionnaire was designed with 14 questions modeled after validated patient satisfaction surveys from the literature. Questions concerning provider-patient language concordance, quality of understanding, and general satisfaction were included. Surveys were administered to families of patients in the General Pediatric Surgery Clinic at our institution. Families were categorized into three groups: English-speaking, regardless of race/ethnicity; Spanish-speaking using interpreter services with an English-speaking medical team; and Spanish-speaking communicating directly with a Spanish-speaking medical team (Hispanic Center for Pediatric Surgery, HCPS). One-way analysis of variance was used to test for group differences.
  
  
  RESULTS
  We administered 226 surveys; 49 were removed due to lack literacy proficiency. Families in the HCPS group reported a higher level of satisfaction than the interpreter and English groups (p<0.01). The HCPS group also indicated improved understanding of the information from the visit (p<0.001). Spanish-speaking only families felt that communicating directly with their health care team in their primary language was more important than their English-speaking counterparts (p<0.001).
  
  
  CONCLUSIONS
  In a pediatric surgery clinic, language concordant care improves patient satisfaction and understanding for Hispanic families in comparison to language discordant care. Other clinics in other surgery sub-specialties may consider using this model to eliminate language barriers and improve patient satisfaction and understanding of surgical care.
authors.affiliation: Division of General Pediatric Surgery, Lucile Packard Children's Hospital at Stanford.
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Dunlap
authors.affiliation: Division of General Pediatric Surgery, Lucile Packard Children's Hospital at Stanford.
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Jaramillo
authors.affiliation: Division of General Pediatric Surgery, Lucile Packard Children's Hospital at Stanford.
authors.forename: Raji
authors.initials: R
authors.lastname: Koppolu
authors.affiliation: Division of General Pediatric Surgery, Lucile Packard Children's Hospital at Stanford.
authors.forename: Robert
authors.initials: R
authors.lastname: Wright
authors.affiliation: Division of Pediatrics, Lucile Packard Children's Hospital at Stanford.
authors.forename: Fernando
authors.initials: F
authors.lastname: Mendoza
authors.affiliation: Division of General Pediatric Surgery, Lucile Packard Children's Hospital at Stanford. Electronic address: mbruzoni@stanford.edu.
authors.forename: Matias
authors.initials: M
authors.lastname: Bruzoni
mesh_terms: D002648:Child; D003144:Communication Barriers; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007802:Language; D008297:Male; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D013043:Specialties, Surgical; D013514:Surgical Procedures, Operative; D014481:United States
keywords: Hispanic patients; Language concordant care; Patient centered care