Self-Reported Barriers to Healthcare and Interpreter Preferences for Patients with Limited-English-Proficiency in an Urban Emergency Department

Main Article Content

Nivedita Poola, MD Rashmi Koul Shreya Sharma Angie Ng, MSW Elana Hayasaka, MD Christina P.C. Borba, PhD, MPH http://orcid.org/0000-0003-3559-9351 Suzanne Sarfaty, MD http://orcid.org/0000-0001-9129-9383 Kathleen Flinton, MSW, LICSW Nicolette Oleng, MD Sondra Crosby, MD http://orcid.org/0000-0002-1672-5407 Linda Piwowarczyk, MD http://orcid.org/0000-0002-0791-9605 Senait Ghebrehiwet, MPH http://orcid.org/0000-0002-9611-9684 Gabrielle A Jacquet, MD, MPH http://orcid.org/0000-0001-9486-5512

Abstract

Introduction: In the United States, limited English proficient (LEP) patients often use emergency departments (ED) as their primary source of healthcare. Beyond language barriers, little is known about what other barriers LEP patients face to utilizing emergency care. The authors attempted to identify other barriers as well as gather data regarding patient preference for interpretation modality.


Methods: A survey was administered to LEP patients at an urban, academic ED from June 2016 to September 2018. Participants rated 17 predetermined barriers and reported preferred interpretation modality.


Results: The study population included 87 LEP participants from 13 countries, speaking 8 primary languages. The most common barriers “of high concern” were “paying the bill” (n=19), “wait time” (n=18), and “belief that professional care probably would not help” (n=15). A majority of participants (n=60, 61%) preferred in-person professional interpreters to other forms of interpretation.


Conclusions: Addressing these specific barriers may improve access and utilization of emergency care for LEP patients. In-person professional interpreters should be utilized whenever possible.

Keywords: Social Determinants of Health, Emergency Care, Interpreter Services, Immigrants, Refugees

Article Details

How to Cite
POOLA, Nivedita et al. Self-Reported Barriers to Healthcare and Interpreter Preferences for Patients with Limited-English-Proficiency in an Urban Emergency Department. Medical Research Archives, [S.l.], v. 8, n. 8, aug. 2020. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2173>. Date accessed: 16 nov. 2024. doi: https://doi.org/10.18103/mra.v8i8.2173.
Section
Research Articles

References

1. United States Census Bureau. Selected Social Characteristics in the United States, 2013-2017. American community survey 5-year estimates.
2. Asgary R, Segar N. Barriers to health care access among refugee asylum seekers. Journal of health care for the poor and underserved. 2011;22(2):506-522.
3. Singh GK, Miller BA. Health, life expectancy, and mortality patterns among immigrant populations in the United States. Canadian journal of public health = Revue canadienne de sante publique. 2004;95(3):14.
4. Pitkin Derose K, Bahney BW, Lurie N. Review: Immigrants and Health Care Access, Quality, and Cost. Vol 66. Los Angeles, CA: SAGE Publications; 2009:355-408.
5. Mahmoud I, Hou XY. Immigrants and the utilization of hospital emergency departments. World journal of emergency medicine. 2012;3(4):245-250.
6. Boise L, Tuepker A, Gipson T, et al. African Refugee and Immigrant Health Needs: Report From a Community House Meeting Project. Progress in Community Health Partnerships: Research, Education, and Action. Johns Hopkins University Press. 2013;7(4).
7. Morris MD, Popper ST, Rodwell TC, et al. Healthcare barriers of refugees post-resettlement. Journal of community health. 2009;34(6):529-538.
8. Campbell RM, Klei AG, Hodges BD, et al. A comparison of health access between permanent residents, undocumented immigrants and refugee claimants in Toronto, Canada. 2014(1557-1920 (Electronic)).
9. Ramirez D, Engel KG, Tang TS. Language interpreter utilization in the emergency department setting: a clinical review. 2008(1049-2089 (Print)).
10. Tarraf W, Vega W Fau, et al. Emergency department services use among immigrant and non-immigrant groups in the United States. J Immigr Minor Health. 2014(1557-1920 (Electronic)).
11. Mahmoud I, Hou XY. Utilisation of Hospital Emergency Departments among Immigrants from Refugee Source-Countries in Queensland. Clinical Medicine and Diagnostics. 2013;3(4):88-91.
12. Mahmoud I, Eley R, Hou XY. Subjective reasons why immigrant patients attend the emergency department. 2015(1471-227X (Electronic)).
13. Norredam M, Mygind A, Nielsen AS, et al. Motivation and relevance of emergency room visits among immigrants and patients of Danish origin. 2007(1101-1262 (Print)).
14. Carrasquillo O, Orav EJ, Brennan TA, et al. Impact of language barriers on patient satisfaction in an emergency department. 1999(0884-8734 (Print)).
15. Mahmoud I, Hou XY, Chu K, et al. Satisfaction with emergency department service among non-English-speaking background patients. Emerg Med Australas. 2014(1742-6723 (Electronic)).
16. Gandhi TK, Burstin HR, Cook ED, et al. Drug complications in outpatients. J Gen Intern Med. 2000;15:149-154.
17. Manson A. Language concordance as a determinant of patient compliance and emergency room use in patients with asthma. . Med Care. 1998;26:1119-1128.
18. Numeroso F, Benatti M, Pizzigoni C, et al. Emergency physician's perception of cultural and linguistic barriers in immigrant care: results of a multiple-choice questionnaire in a large Italian urban emergency department. World J Emerg Med. 2015;6(2):111-117.
19. Weinick RM, Krauss NA. Racial/ethnic differences in children’s access to care. Am J Pub Health. 2000;90:1771-1774.
20. Lee ED, Rosenberg CR, Sixsmith DM, et al. Does a physician-patient language difference increase the probability of hospital admission? . Acad Emerg Med. 1998;5:86-89.
21. LeSon S, Gershwin ME. Risk factors for asthmatic patients requiring intubation. II. Observations in teenagers. J Asthma. 1995;32:379-389.
22. Sarver J, Baker DW. Effect of language barriers on follow-up appointments after an emergency department visit. . J Gen Intern Med. 2000;15:256-264.
23. Carrillo JE, Carrillo VA, Perez HR,et al. Defining and targeting health care access barriers. J Health Care Poor Underserved. 2011;22(2):562-575.
24. Kannan VD, Veazie PJ. Predictors of avoiding medical care and reasons for avoidance behavior. Medical care. 2014;52(4):336.
25. Taber J, Leyva B, Persoskie A. Why do People Avoid Medical Care? A Qualitative Study Using National Data. Journal of General Internal Medicine. 2015;30(3):290-297.
26. Juckett G, Unger K. Appropriate Use of Medical Interpreters. Am Fam Physician. 2014;90(7):476-480.
27. Karliner LS, Jacobs EA, Chen AH, et al. Do Professional Interpreters Improve Clinical Care for Patients with Limited English Proficiency? A Systematic Review of the Literature. Health Services Research. 2006.