This project developed and tested a model for examining costs associated with medical errors related to (A) barriers to physician-patient communications and understanding versus (B) the provision of a variety of language appropriate services to promote communication and understanding in clinical encounters. An expert panel with expertise in physician-patient communications, language barriers, medical errors, health care quality, cost-benefit analyses and econometrics collaborated in the development of an approach to examining language barriers in various clinical health care settings. The panel determined that the project should address health care service utilization and established measures of both quality and medical error. The panel developed a conceptual model that could serve as a research framework for studies of the impacts of provider-patient language barriers on health care quality and costs. A limited study conducted to test the model, showed that the model worked.
The expert panel subsequently made 38 recommendations relative to the scope of future research, conceptual model, localized study and its findings, further research, and other programmatic and policy-relevant actions. Examples of panel recommendations include: broadening research to include all the patient-provider interactions; expanding examination of impact to include health care outcomes; examining different approaches to providing language support; broadening research beyond mere linguistic issues (to culture, etc.); applying quality indicators identified by the Institute of Medicine; and considering using randomized control trials in future research. The project demonstrated that the model could be used to conduct research to answer questions about costs and other impacts of language barriers in health care. More well-controlled studies utilizing the model are needed to investigate the impacts of these barriers in order to better inform health care policy and programmatic decision-making for racial, ethnic, and linguistic minorities in the United States. Panel members expect that future studies will likely produce findings that will build support for the notion that understanding and being understood is a critical component of health care quality, regardless of primary language spoken or English proficiency status.
Report Title: Assessing the Impact of Provider-Patient Language Barriers on Health Care Costs and Quality http://aspe.hhs.gov/pic/fullreports/06/7711.htm
Agency Sponsor: OPHS-OMH, Office of Minority Health
Federal Contact: Hawks, Betty, 240-453-2882
Performer: Cosmos Corporation; Bethesda, MD
PIC ID: 7711