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Healthcare Experiences of Limited English-Proficient Asian American Patients

A Cross-Sectional Mail Survey

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Abstract

Background: Among patients with limited English-language proficiency (LEP), provider-patient language discordance is related to lower patient satisfaction. However, little is known about how language barriers are associated with specific patient experiences, and how these experiences in turn may influence patient satisfaction.

Objective: To evaluate the degree of health education and the quality of interpersonal care that occurs during patient visits, and their associations with patient satisfaction, in LEP Asian American patients.

Methods: A cross-sectional mail survey was conducted in 2746 LEP Chinese and Vietnamese patients aged ≥18 years from 11 community health centers in eight US cities. We examined self-reported healthcare experiences of LEP patients who had visits to a language concordant (speaks the patient’s language) or discordant (does not speak the patient’s language) provider over the previous month. Multivariable logistic regressions were conducted to examine the associations between interpersonal care, discussions of health-related behaviors, and patient satisfaction.

Results: Discussions of health-related behaviors and the quality of interpersonal care received were independent predictors of patient satisfaction (p<0.001). For language-discordant visits without access to an interpreter, patients who received poor-quality interpersonal care were more likely to be dissatisfied with the visit (adjusted odds ratio [AOR] 2.44; 95% CI 1.67, 3.57) and with the provider (AOR 4.43; 95% CI 1.71, 11.48) [both p<0.01].

Conclusions: Improving the quality of interpersonal care and the degree of health-related discussions may result in greater satisfaction among LEP patients. The quality of the provider’s interpersonal care is especially important to patient satisfaction. Interpreter services may alleviate some disparities in care.

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Acknowledgments

This study was funded by the Agency for Healthcare Research and Quality (grant no. R01-HS10 316) and the Commonwealth Fund (grant no. 20020110). The authors would like to thank Michael Massagli, PhD, and Brian Clarridge, PhD, for their extensive contributions to questionnaire development and data collection. The authors have no conflicts of interest that are directly relevant to the content of this study.

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Authors and Affiliations

  1. Division of General Internal Medicine and Primary Care and Health Policy Research Institute, University of California, Irvine School of Medicine, Irvine, California, USA

    Quyen Ngo-Metzger & Dara H. Sorkin

  2. Beth Israel Deaconess Medical Center, Division of General Medicine and Primary Care, Harvard Medical School, Boston, Massachusetts, USA

    Russell S. Phillips

Authors
  1. Quyen Ngo-Metzger
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  2. Dara H. Sorkin
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  3. Russell S. Phillips
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Correspondence to Quyen Ngo-Metzger.

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Ngo-Metzger, Q., Sorkin, D.H. & Phillips, R.S. Healthcare Experiences of Limited English-Proficient Asian American Patients. Patient-Patient-Centered-Outcome-Res 2, 113–120 (2009). https://doi.org/10.2165/01312067-200902020-00007

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