THE IMPACT OF LANGUAGE AS A BARRIER TO EFFECTIVE HEALTH-CARE IN AN UNDERSERVED URBAN HISPANIC COMMUNITY

Background: Language barriers between patient and physician impact upo n effective health care. This phenomenon is not well studied in the li terature. Methods: A survey was created in English and Spanish, and ad ministered at the ambulatory site for medical housestaff and faculty a t a teaching hospital. ''Cases'' were defined as patients who reported using a translator or as having poor English skills. Patients who rep orted not using a translator and having good English skills served as controls. Both groups were predominantly of Hispanic origin. Results: Analysis revealed 68 cases and 193 controls. The survey completion rat e was 96%. The data were predominantly categorical. Chi-square analysi s was utilized. Both groups responded that understanding medication si de effects corresponds to compliance (87% cases vs 93% controls, p = 0 .18). More cases responded that side effects were not explained (47% v s 16%, p < 0.001). More controls reported satisfaction with medical ca re (93% vs 84%, p < 0.05). More controls agreed that their doctors und erstood how they were feeling, with statistical significance in Hispan ic subset analysis (87% vs 72%, p < 0.05). Both groups felt they had e nough time to communicate with their doctors (89% vs 88%, p = 0.86). M ore cases than controls reported having had a mammogram within the las t 2 years (78% vs 60%, p < 0.05). Conclusions: Lack of explanation of side effects to medication appeared to correlate negatively with compl iance with medication. The language barrier correlated negatively with patient satisfaction. Cases reported more preventive testing; test or dering map replace dialogue.