Health Science Report: Barriers in Healthcare for Non-English Speakers

This report analyzes the barriers and enablers to accessing healthcare for non-English speaking patients. It highlights that language differences between healthcare providers and patients significantly impact the quality of care, leading to disparities in preventive services and overall health outcom...Read More

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Barriers and enablers to accessing care in patients who do not speak English
Non-English speaking patients always remain at health disadvantages due to lesser access
to fewer preventive services and access to care compared to English speaking patients. Language
difference between care provider and patient, and the increase in the number of patients with
limited English language proficiency is one of the major barrier to effective and quality care.
Linguistic barrier contribute to misunderstanding among patients in the area of diagnosis,
treatment and options to access care. This limitation in English language proficiency also
increases the risk for adverse events in such patients compared to English speaking patients.
They face difficulty in understanding instruction and thereby remain oblivious about the care
options. Research has shown that patients with limited English language proficiency have greater
risk of line infections, surgical delays, readmission in hospitals and longer hospital stays due to
poor and timely access of health care service. The interactions with health care staffs is seriously
affected in such cases and worse health outcome is reported due to limited access to health care
and fewer health care visits (Calo et al., 2015).
Gap in language and communications in health care staffs also contribute to barriers in
accessing care for limited English speaking patients. Evidence points out that when patients and
physician do not speak same language,, effective communication process is affected contributing
to poor access to high quality care. In case of an area with high percentage of limited English
proficiency patient, hospital must provided patients with access to professional interpreters to
decrease readmission rates and promotes time care and treatment of patients. Such situation also
creates challenges for health care system because of rise in communication barriers due to

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language gap and this also affects the capability of the health care professional to provide high
quality patients centered care (Karliner, Pérez-Stable, & Gregorich, 2017).
Due to the increase in diversity of the patients population in terms of language and
culture, more attention to mitigating language and cultural barrier is likely to act as enabler to
improve access to care in patients who do not speak English. Access to professional interpreters
is most effective in address language barrier in care delivery and improving communication
between patients and care providers. Interpreters ensure that patients can use resources in a better
way. Study also shows that professional interpreters decrease length of stay and rehospitalization
rates in limited English speaking patients (Basu, Costa & Jain, 2017).
Poor language concordance between care provider and patient also contribute to
dilemmas for physician in the delivery of care. Effective communication and employing other
strategies to communicate with such patients also becomes difficult due to time constraints/
acuity of situations and ease of availability of translation aid. Physicians can overcome these
difficulties if they get appropriate support from health care organization to understand patients
concerns and make the right judgment. Team based approach an open line of communication
may also mitigate the difficulties faced by non-English speaking patients (Parsons et al., 2014).
As language and culture are closely linked to each other and they also results in differential
access to case, focusing on cultural competency skills in health care staffs is also critical to
improve accessibility to health care service (Betancourt et al., 2016).

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Reference
Basu, G., Costa, V. P., & Jain, P. (2017). Clinicians’ Obligations to Use Qualified Medical
Interpreters When Caring for Patients with Limited English Proficiency. AMA Journal of
Ethics, 19(3), 245.
Betancourt, J.R., Green, A.R., Carrillo, J.E. and Owusu Ananeh-Firempong, I.I., 2016. Defining
cultural competence: a practical framework for addressing racial/ethnic disparities in
health and health care. Public health reports.
Calo, W. A., Cubillos, L., Breen, J., Hall, M., Rojas, K. F., Mooneyham, R., ... & Garcia, N.
(2015). Experiences of Latinos with limited English proficiency with patient registration
systems and their interactions with clinic front office staff: an exploratory study to inform
community-based translational research in North Carolina. BMC health services
research, 15(1), 570.
Karliner, L. S., Pérez-Stable, E. J., & Gregorich, S. E. (2017). Convenient access to professional
interpreters in the hospital decreases readmission rates and estimated hospital
expenditures for patients with limited English proficiency. Medical care, 55(3), 199-206.
Parsons, J. A., Baker, N. A., Smith-Gorvie, T., & Hudak, P. L. (2014). To ‘Get by’or ‘get help’?
A qualitative study of physicians’ challenges and dilemmas when patients have limited
English proficiency. BMJ open, 4(6), e004613.