Language Barriers and Access to Care

Background: Research has demonstrated lower access to healthcare services by immigrant patients in comparison to native people. Cultural and linguistic differences have been considered as main factors that impede this access and as barriers to creating an effective relationship between immigrant patients and health professionals. Objective: The aim of this study was to better understand and synthesize the available evidence regarding the impact of immigrant patients’ language proficiency on access to health care. Methods: A systematic literature search was performed to identify studies published between January 2000 and January 2019 that examined the impact of language proficiency on access to and use of health services by immigrant patients. Only articles in English were included. Cross-referencing of the identified articles was also performed. Results: A total of 140 publications was identified through online databases. In all 24 studies were reviewed, and the results were reported using four interrelated themes identified from the articles. These reports consistently showed a clear association between inadequate language ability and underuse of health care services, ineffective communication, and increased use of emergency care by immigrant patients. Identifying factors that can influence access to care, applying immigrant-friendly solutions such as provision of professional interpreters, and encouraging culturally and linguistically sensitive education may improve the quality of care and increase access to care. One study recommended utilisation of communication technologies such as telemedicine to bridge the communication gap and increase accessibility of healthcare services by immigrant patients. Conclusions: All included studies indicated that language barriers hindered access to healthcare services. The data resulting from this study can update policy and practical solutions for language barriers on access to care by immigrant patients and provide an agenda for further investigations.

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Using Cognitive Work Analysis to Design Communication Support Tools for Patients with Language Barriers

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1541931213601514 ◽

2017 ◽

Vol 61 (1) ◽

pp. 120-124 ◽

Cited By ~ 1

Author(s):

Natalie C. Benda1 ◽

Jeffrey Higginbotham ◽

Rollin J. Fairbanks ◽

Li Lin ◽

Ann M. Bisantz

Keyword(s):

Health Literacy ◽

Access To Care ◽

Healthcare Disparities ◽

Language Barriers ◽

Quality And Safety ◽

Cognitive Work Analysis ◽

Communication Support ◽

Work Analysis ◽

Support Tools ◽

Cognitive Work

Patients with language barriers face healthcare disparities associated with access to care, satisfactions with care, and the quality and safety of the care they receive. The central solution to addressing these barriers is through the use of professional interpreters but there are difficulties associated with consistently using these services. This study used cognitive work analysis to identify the goals, constraints and affordances associated with patient communication to develop support requirements for communicating with patients with language barriers. Specific communication support objectives discovered included: supporting various cultural background and levels of health literacy, identifying when information is not properly conveyed, and providing a means to convey the information in a different way to allow for subsequent checks in understanding. These objectives can be utilized as inputs for the development of tools to support communication with patients with language barriers.

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