Annals of Emergency Medicine
Volume 57, Issue 3 , Pages 248-256.e4 , March 2011

Examining Effectiveness of Medical Interpreters in Emergency Departments for Spanish-Speaking Patients With Limited English Proficiency: Results of a Randomized Controlled Trial

  • Ann D. Bagchi, PhD

      Affiliations

    • Division of Health, Mathematica Policy Research, Princeton, NJ
    • Corresponding Author InformationAddress for reprints: Ann D. Bagchi, PhD, Mathematica Policy Research, 600 Alexander Park, Princeton, NJ 08540; 609-716-4554, fax 609-799-0005
  • ,
  • Stacy Dale, MPA

      Affiliations

    • Division of Health, Mathematica Policy Research, Princeton, NJ
  • ,
  • Natalya Verbitsky-Savitz, PhD

      Affiliations

    • Division of Health, Mathematica Policy Research, Washington, DC
  • ,
  • Sky Andrecheck, MS

      Affiliations

    • Division of Health, Mathematica Policy Research, Washington, DC
  • ,
  • Kathleen Zavotsky, MS, RN

      Affiliations

    • Emergency Department, Robert Wood Johnson University Hospital, New Brunswick, NJ
  • ,
  • Robert Eisenstein, MD

      Affiliations

    • Emergency Department, Robert Wood Johnson University Hospital, New Brunswick, NJ

Received 4 January 2010 ,Revised 27 April 2010 ,Accepted 25 May 2010.

References 

  1. Goode TD, Dunne MC, Bronheim SM. The Evidence Base for Cultural and Linguistic Competency in Health Care. New York, NY: Commonwealth Fund; 2006;
  2. Ramirez D, Engel K, Tang T. Language interpreter utilization in the emergency department setting: a clinical review. J Health Care Poor Underserved. 2008;19:352–362
  3. Mazor SS, Hampers LC, Chande VT, et al. Teaching Spanish to pediatric emergency physicians: effects on patient satisfaction. Arch Pediatr Adolesc Med. 2002;156:693–695
  4. Boudreaux ED, O'Hea EL. Patient satisfaction in the emergency department: a review of the literature and implications for practice. J Emerg Med. 2004;26:13–26
  5. Garcia EA, Roy C, Okada PJ, et al. A comparison of the influence of hospital-trained, ad hoc, and telephone interpreters on perceived satisfaction of limited English-proficient parents presenting to a pediatric emergency department. Pediatr Emerg Care. 2004;20:373–378
  6. Gany F, Leng J, Shapiro E, et al. Patient satisfaction with different interpreting methods: a randomized controlled trial. J Gen Intern Med. 2007;22:312–318
  7. Ferguson WJ, Candib LM. Culture, language, and the doctor-patient relationship. Fam Med. 2002;34:353–361
  8. Wilson E, Chen AH, Grumbach K, et al. Effects of limited English proficiency and physician language on health care comprehension. J Gen Intern Med. 2005;20:800–806
  9. Nápoles AM, Santoyo-Olsson J, Karliner LS, et al. Clinician ratings of interpreter mediated visits in underserved primary care settings with ad hoc, in-person professional and video conferencing modes. J Health Care Poor Underserved. 2010;21:301–317
  10. Thomas EJ, Burstin HR, O'Neil AC, et al. Patient non-compliance with medical advice after the emergency department visit. Ann Emerg Med. 1996;27:49–55
  11. Murray MJ, Le Blanc CH. Clinic follow-up from the emergency department: do patients show up?. Ann Emerg Med. 1996;27:56–58
  12. Baker DW, Parker RM, Williams MV, et al. Use and effectiveness of interpreters in an emergency department. JAMA. 1996;275:783–788
  13. Baker DW, Hayes R, Fortier JP. Interpreter use and satisfaction with interpersonal aspects of care for Spanish-speaking patients. Med Care. 1998;36:1461–1470
  14. Landon BE, Rschovsky JD, Pham HH, et al. Leaving medicine: the consequences of physician dissatisfaction. Med Care. 2006;44:234–242
  15. 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 Serv Res. 2007;42:727–754
  16. Williams ES, Manwell LB, Konrad TR, et al. The relationship of organizational culture, stress, satisfaction and burnout with physician-reported error and suboptimal patient care: results from the MEMO study. Health Care Manage Rev. 2007;32:203–212
  17. Babitsch B, Braun T, Borde T, et al. Doctor's perception of doctor-patient relationships in emergency departments: what roles do gender and ethnicity play?. BMC Health Serv Res. 2008;8:82–91
  18. Molinari DL, Monserud M. Rural nurse cultural self-efficacy and job satisfaction. J Transcult Nurs. 2009;20:211–218
  19. Rydman RJ, Roberts RR, Albrecht GL, et al. Patient satisfaction with an emergency department asthma observation unit. Acad Emerg Med. 1999;6:178–183
  20. Worthington K. Customer satisfaction in the emergency department. Emerg Med Clin North Am. 2004;22:87–102
  21. Taylor C, Benger JR. Patient satisfaction in emergency medicine. Emerg Med J. 2004;21:528–532
  22. Park CY, Lee MA, Epstein AJ. Variation in emergency department wait times for children by race/ethnicity and payment source. Health Serv Res. 2009;44:2022–2039
  23. Flores G. The impact of medical interpreter services on the quality of health care: a systematic review. Med Care Res Rev. 2005;62:255–299
  24. Jacobs EA, Chen AH, Karliner LS, et al. The need for more research on language barriers in health care: a proposed research agenda. Milbank Q. 2006;84:111–133
  25. Bloom HS. Randomizing groups to evaluate place-based programs. In:  Bloom HS editors. Learning More From Social Experiments. New York, NY: Russell Sage Foundation; 2005;p. 115–172
  26. Raudenbush SW. Statistical analysis and optimal design for cluster randomized trials. Psychol Methods. 1997;2:173–185
  27. Bernstein J, Bernstein E, Dave A, et al. Trained medical interpreters in the emergency department: effects on services, subsequent charges, and follow-up. J Immigr Health. 2002;4:171–176
  28. Hampers LC, McNulty JE. Professional interpreters and bilingual physicians in a pediatric emergency department. Arch Pediatr Adolesc Med. 2002;156:1100–1113
  29. Carrasquillo O, Orav J, Brennan TA, et al. Impact of language barriers on patient satisfaction in an emergency department. J Gen Intern Med. 1999;14:82–87
  30. Centers for Medicare & Medicaid Services. Encuesta CAHPS® Sobre Atención Hospitalaria (US Department of Health & Human Services Web site). http://www.hcahpsonline.org/Files/V4%200%201-20-2009%20Appendix%20B%20-HCAHPS%20Mail%20Survey%20Materials%20(Spanish).pdfAccessed August 7, 2009
  31. Kamath CC, O'Fallon WM, Offord KP, et al. Provider satisfaction in clinical encounters with ethnic immigrant patients. Mayo Clin Proc. 2003;78:1353–1360
  32. Raudenbush SW, Bryk AS. Hierarchical Linear Models: Applications and Data Analysis Methods. 2nd ed.. Thousand Oaks, CA: Sage Publications; 2002;
  33. Raudenbush SW, Bryk A, Cheong YF. HLM 6: Hierarchical Linear and Nonlinear Modeling. Lincolnwood, IL: Scientific Software International, Inc; 2004;
  34. Woodbury D, Tracy D, McKnight E. Does considering severity of illness improve interpretation of patient satisfaction data?. J Healthc Qual. 1998;20:33–40
  35. Cunningham H, Cushman LF, Akuete-Penn C, et al. Satisfaction with telephonic interpreters in pediatric care. J Natl Med Assoc. 2008;100:429–434
  36. Fernandez A, Schillinger D, Grumbach K, et al. Physician language ability and cultural competence: an exploratory study of communication with Spanish-speaking patients. J Gen Intern Med. 2004;19:167–174
  37. Garman AN, Garcia J, Hargreaves M. Patient satisfaction as a predictor of return-to-provider behavior: analysis and assessment of financial implications. Qual Manag Health Care. 2004;13:75–80
  38. Sun BC, Adams J, Orav EJ, et al. Determinants of patient satisfaction and willingness to return with emergency care. Ann Emerg Med. 2000;35:426–434
  39. Paras M. Straight Talk: Model Hospital Policies and Procedures on Language Access. Oakland, CA: California Health Care Safety Net Institute; 2005;
  40. Wirthlin Worldwide. Hablamos Juntos: We Speak Together. Orem, UT: Wirthlin Worldwide; 2001;
  41. Hasnain-Wynia R, Yonek J, Pierce D. Hospital Language Services for Patients With Limited English Proficiency: Results From a National Survey. Chicago, IL: Health Research and Educational Trust; 2006;
  42. Wilson-Stronks A, Galvez E. Hospitals, Language, and Culture: A Snapshot of the Nation. Oakbrook Terrace, IL: Joint Commission & California Endowment; 2007;

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 Supervising editor: Donald M. Yealy, MD

 Author contributions: ADB, SD, and NV-S conceived the study, designed the trial, and obtained research funding. ADB recruited participating hospitals and oversaw recruitment of field staff and interviewers. ADB, KZ, and RE completed institutional review board applications and reporting. ADB, SD, and KZ supervised the conduct of the trial and data collection. NV-S carried out randomization procedures and led statistical analyses, with assistance from SD and SA. ADB had primary responsibility for drafting the article, with all authors contributing substantially to the original draft and subsequent revisions. ADB takes responsibility for the paper as a whole.

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. This project was funded under grant number 55879 by the Robert Wood Johnson Foundation.

 Please see page 249 for the Editor's Capsule Summary of this article.

 Publication date: Available online August 3, 2010.

PII: S0196-0644(10)00557-3

doi: 10.1016/j.annemergmed.2010.05.032

Annals of Emergency Medicine
Volume 57, Issue 3 , Pages 248-256.e4 , March 2011