Health Care Quality Perceptions among Foreign-Born Latinos and the Importance of Speaking the Same Language
Health Care Quality Perceptions among Foreign-Born Latinos and the Importance of Speaking the Same Language
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DOI：
10.3122/jabfm.2010.06.090264
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发表时间：
2010-11-01
影响因子：
2.9
通讯作者：
Tarraf, Wassim
中科院分区：
文献类型：
--
作者：
Gonzalez, Hector M.;Vega, William A.;Tarraf, Wassim
目的：探讨在美国外国出生的拉丁裔患者的英语水平、患者-提供者语言一致性和医疗保健质量之间的关系。方法：全国概率样本数据（来自皮尤西班牙裔中心/罗伯特伍德约翰逊基金会拉丁裔健康调查）通过电话采访分析外国出生的拉丁裔成年人（n = 2921；年龄在18岁及以上）。有3个主要结果与临床经验相关，使用自我报告的混乱，沮丧，由于英语能力和口音偏见而接受的护理质量差的感知，以及护理质量的总体评分。患者英语水平和医患语言一致性是主要预测因素。结果：患者的英语水平与3项临床经验测量无显著相关性，与整体护理质量评分相关性不大。语言一致性与混淆、沮丧和语言相关的低质量评分的可能性显著相关，并与患者报告的整体护理质量呈正相关。此外，当两者同时建模时，提供者的语言一致性减弱了患者英语熟练程度影响的统计学意义。结论：患者-提供者语言一致性在拉美裔外国出生患者的沟通障碍中起重要作用。我们的研究结果表明，尽管患者的语言能力对医疗质量评级很重要，但更重要的可能是患者和提供者使用同一种语言。（中国医学杂志2010；23:745-752）
Objectives: To examine the relationship between patients' English proficiency, patient-provider language concordance, and health care quality among foreign-born Latinos in the United States.Methods: National probability sample data (from the Pew Hispanic Center/Robert Wood Johnson Foundation Latino Health Survey) were analyzed from telephone interviews with foreign-born Latino adults (n = 2921; aged 18 years and older). There were 3 main outcomes related to clinical experiences using self-reports of confusion, frustration, and perception of poor quality of care received because of English-speaking ability and accent bias, as well as an overall rating of care quality. Patients' English proficiency and patient-provider language concordance were the chief predictors.Results: Patients' English proficiency was not significantly associated with the 3 clinical experiences measures and marginally so with overall care quality ratings. Language concordance was significantly associated with a lower likelihood of confusion, frustration, and language-related poor quality ratings, and was positively associated with patient-reported overall quality of care. In addition, providers' language concordance attenuated the statistical significance of the effects of patients' English proficiency when both were modeled simultaneously.Conclusion: Patient-provider language concordance plays an important role in communication barriers among foreign-born Latino patients. Our findings indicate that although patients' language proficiency is important to health care quality ratings, what may matter more is when patient and provider speak the same language. (J Am Board Fam Med 2010;23:745-752.)