Patient-physician Language Concordance and Primary Care Screening Among Spanish-speaking Patients

Datos Bibliográficos

ID9104057
AutoresPracha Peter Eamranond, Pracha Eamranond (0000-0001-6739-3003, Brigham and Women's Hospital, autor de correspondencia), Roger B Davis (0000-0003-3330-3123, autor de correspondencia), Richard S Phillips (0000-0002-7281-7154, autor de correspondencia), RUSSELL S PHILLIPS, Christina C Wee (0000-0002-0439-5746, autor de correspondencia)
Año2011
Volumen49
Número7
Páginas668-672
Fecha de publicación2011-07-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e318215d803
PMID21478772
PMCIDPMC3117916
OpenAlexW2001191394
IdiomaEN
Citas recibidas9
Referencias citadas19

BACKGROUND: Language discordance between patient and physician is associated with worse patient self-reported healthcare quality. As Hispanic patients have low rates of cardiovascular and cancer screening, we sought to determine whether patient-physician language concordance was associated with differences in rates of screening. METHODS: We performed a retrospective medical record review of 101 Spanish-speaking patients cared for by 6 Spanish-speaking PCPs (language-concordant group) and 205 Spanish-speaking patients cared for by 44 non-Spanish-speaking PCPs (language-discordant group). Patients were included in the study if they were of age 35 to 75 years and had used interpreter services 2001 to 2006 in 2 Boston-based primary care clinics. Our outcomes included screening for hyperlipidemia, diabetes, cervical cancer, breast cancer, and colorectal cancer with age-appropriate and sex-appropriate subgroups. Our main predictor of interest was patient-physician language concordance. In multivariable modeling, we adjusted for age, sex, insurance status, number of primary care visits, and comorbidities. We adjusted for clustering of patients within individual physicians and clinic sites using generalized estimating equations. RESULTS: Patients in the language-discordant group tended to be female compared with patients in the language-concordant group. There were no significant differences in age, insurance status, number of primary care visits, or Charlson comorbidity index between the 2 groups. Rates of screening for hyperlipidemia, diabetes, cervical cancer, and breast cancer were similar for both language-concordant and language-discordant groups. However, patients in the language-concordant group were less likely to be screened for colorectal cancer compared with the language-discordant group risk ratio 0.78 (95% confidence interval, 0.61-0.99) after multivariable adjustment. CONCLUSIONS: This study finds that Spanish-speaking patients cared for by language-concordant PCPs were not more likely to receive recommended screening for cardiovascular risk factors and cancer. Furthermore, language concordance was associated with lower likelihood colorectal cancer screening. Further research is needed to examine which conditions are optimal to improve cardiovascular and cancer screening for Spanish-speaking patients, particularly for colorectal cancer, which has a low rate of screening

Breast cancer · Cancer · Cancer screening · Comorbidity · Concordance · Diabetes mellitus · Family medicine · Health care · Medical record · Primary care · Primary care physician · Internal Medicine · Interpreting and Communication in Healthcare · Medicine · Neurobiology of Language and Bilingualism · Patient-Provider Communication in Healthcare