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.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Pediatric SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Census 2000 summary file 3, matrices P19, P20, PCT13, and PCT14.2000 ([Washington, DC])
- Language use in the United States: 2007.in: American community survey reports. 2010 ([Washington, DC, Available at: http://www.census.gov/prod/2010pubs/acs-12.pdf. Accessed on April 3, 2011])
- Effect of Spanish interpretation method on patient satisfaction in an urban walk-in clinic.J Gen Intern Med. 2002; : 641-646
- Acculturation, access to care, and use of preventative services by Hispanics: findings from HHANES 1982–84.Am J Public Health. 1990; 80 ([Suppl]): 11-19
- The impact of language barriers on the health care of Latinos in the United States: a review of the literature and guidelines for practice.J Midwifery Women’s Health. 2002; 47: 80-86
- Providing high-quality care for limited English proficient patients: the importance of language concordance and interpreter use.J Gen Intern Med. 2007; 22: 324-330
- Language barriers in medicine in the United States.JAMA. 1995; 273: 724-728
- Racial and ethnic differences in parents’ assessments of pediatric care in Medicaid managed care.Health Serv Res. 2001; 36: 575-594
- Are Latinos less satisfied with communication by health care providers?.J Gen Intern Med. 1999; 14: 409-417
- Impact of language barriers on patient satisfaction in an emergency department.J Gen Intern Med. 1999; 14: 82-87
- Race/ethnicity, language, and patients’ assessments of care in Medicaid managed care.Health Serv Res. 2003; 38: 789-808
- Patient-reported outcome measures: the importance of patient satisfaction in surgery.Surgery. 2009; 146: 435-443
- The diverse surgeons initiative: an effective method for increasing the number of under-represented minorities in academic surgery.J Am Coll Surg. 2010; 211: 561-566
- Minorities in academic medicine: review of the literature.J Vasc Surg. 2010; 51: 53S-58S
- The case for diversity in academic internal medicine.Am J Med. 2004; 116: 284-289
- Major deficit in the number of underrepresented minority academic surgeons persists.Ann Surg. 2008; 248: 704-711
- Sullivan Commission’s report on health professions diversity.National Academies Press, Washington DC2004 ([Available at: http://www.jointcenter.org/healthpolicy/docs/SullivanExecutiveSummary.pdf. Accessed on April 4, 2011])
- Smedley B. Stith A. Nelson A. Institute of Medicine. Unequal treatment: confronting racial and ethnic disparities in health care. National Academies Press, Washington, DC2003
- Strategies for improving the diversity of the health professions.The California Endowment, Woodland Hills2003 ([Available at http://familymedicine.medschool.ecsf.edu/pdf/div_strategies.pdf. Accessed April 3, 2011])
- Access barriers to health care for Latino Children.Arch Pediatr Adolesc Med. 1998; 152: 1119-1125
- Reducing health disparities for hispanic children with special health care needs.in: A report to the US Maternal and Child Health Bureau from the National Center for Community-Based Services. 2013
Article info
Publication history
Published online: January 20, 2015
Accepted:
December 22,
2014
Received in revised form:
December 1,
2014
Received:
October 14,
2014
Footnotes
☆Presented at the Surgical Forum in the American College of Surgeons Annual Meeting, San Francisco, October 2014.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
