This Week in PubHub: Health Care and Language Services

(Kyoko Uchida manages PubHub, the Foundation Center's online catalog of foundation-sponsored publications. In her last post, she wrote about health and the environment.)

Navigating the healthcare system -- with its Kafkaesque insurance rules, unfamiliar medical terms, and often-difficult decisions -- is complicated enough when you speak the language. How much more confusing would it be if one had only limited proficiency in English? How might problematic patient-provider communication affect access to care, the quality of care received, and health outcomes? This week's Featured Topic reports highlight the importance of language services in achieving more equitable outcomes in health care.

Using Professionally Trained Interpreters to Increase Patient/Provider Satisfaction: Does It Work?, (Mathematica Policy Research) illustrates how patients, doctors, and nurses are all better served when trained medical interpreters are available. Among other things, the study found that using professional interpreter services in emergency rooms "dramatically increased satisfaction" compared with telephone language services or ad hoc services.

According to Talking With Patients: How Hospitals Use Bilingual Clinicians and Staff to Care for Patients With Language Needs, a 2009 report from the George Washington University School of Public Health and Health Services, only three out of ten hospitals surveyed have paid staff interpreters. Indeed, half use volunteers, with only one in four of those requiring interpreter training or a course on medical interpreting.

The Safety Net Institute report Improving Care for Individuals With Limited English Proficiency: Facilitators and Barriers to Providing Language Services in California Public Hospitals evaluates efforts by twelve California public hospitals to provide better language services by putting organizational policies and procedures in place, providing staff training, and collecting patients' primary language data, among other steps. Remaining barriers include the inability to ensure systematic data collection, communicate patients' language needs across departments, or provide interpreter services at each point of contact and at all hours.

Nor is it only in hospital settings that interpreter services are critically needed. As the Robert Wood Johnson Foundation report "No One Asked Me": Latinos' Experiences With Massachusetts Health Care Reform notes, the experience since 2006 of low-income Latinos with healthcare reform in that state underscores the importance of community-based programs in helping disadvantaged populations obtain health insurance. Similarly, provisions in the 2010 Patient Protection and Affordable Care Act will not expand coverage as much might be the case without efforts to assist those who face language barriers.

What more should be done to improve healthcare access and quality for all patients? Let us know in the comments section below. In the meantime, don’t forget to visit PubHub and browse annotated links to the almost 1,500 health-related reports there.

-- Kyoko Uchida