Language barriers, physician-patient language concordance, and glycemic control among insured Latinos with diabetes: the Diabetes Study of Northern California (DISTANCE).
Language barriers, physician-patient language concordance, and glycemic control among insured Latinos with diabetes: the Diabetes Study of Northern California (DISTANCE).
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被保险的拉丁裔与糖尿病的语言障碍，医师患者语言一致性和血糖控制：北加州的糖尿病研究（距离）。
DOI：
10.1007/s11606-010-1507-6
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发表时间：
2011-02
影响因子：
5.7
通讯作者：
Karter, Andrew J.
中科院分区：
文献类型：
--
作者：
Fernandez, Alicia;Schillinger, Dean;Warton, E. Margaret;Adler, Nancy;Moffet, Howard H.;Schenker, Yael;Salgado, M. Victoria;Ahmed, Ameena;Karter, Andrew J.
关键词：
很大一部分患有糖尿病的美国拉丁美洲人英语水平有限（LEP）。医疗保健中的语言障碍是否会导致血糖控制不良尚不清楚。评估有限英语水平（LEP）和血糖控制之间的关联，以及这种关联是否会因拥有语言一致的医生而改变。采用2005-2006年北方加州糖尿病研究数据的横断面观察性研究（DISTANCE）。患者在有口译服务的管理式护理环境中接受护理，并自我报告他们的英语能力和医生的西班牙语能力。结果是血糖控制不良（糖化血红蛋白A1 c> 9%）。拉丁裔LEP患者（n = 510）和拉丁裔英语使用者（n = 2，683）中血糖控制不良患者的未校正百分比相似，两组均高于白人（n = 3，545）（21% vs 18% vs 10%，p < 0.005）。这种关系因患者-提供者语言一致性而显著不同（交互作用p < 0.01）。语言不一致医生的LEP患者（n = 115）比语言一致医生的LEP患者（n = 137）血糖控制不良的可能性更大（27.8% vs 16.1% p = 0.02）。在控制了潜在的人口统计学和临床混杂因素后，语言一致的医生的LEP拉丁裔与拉丁裔英语使用者血糖控制不良的几率相似（OR 0.89; CI 0.53-1.49），而语言不一致的医生的LEP拉丁裔比拉丁裔英语使用者血糖控制不良的几率更大（OR 1.76; CI 1.04-2.97）。在LEP拉丁裔中，语言不一致的医生与血糖控制显著较差相关（OR 1.98; CI 1.03-3.80）。语言障碍导致拉丁美洲糖尿病患者的健康差异。有限的英语水平是一个独立的预测因素，为血糖控制不良投保美国拉丁美洲糖尿病患者，一个协会没有观察到的护理时，由语言一致的医生。未来的研究应该确定是否增加语言一致的护理策略可以改善美国拉丁裔LEP患者的血糖控制。
A significant proportion of US Latinos with diabetes have limited English proficiency (LEP). Whether language barriers in health care contribute to poor glycemic control is unknown. To assess the association between limited English proficiency (LEP) and glycemic control and whether this association is modified by having a language-concordant physician. Cross-sectional, observational study using data from the 2005–2006 Diabetes Study of Northern California (DISTANCE). Patients received care in a managed care setting with interpreter services and self-reported their English language ability and the Spanish language ability of their physician. Outcome was poor glycemic control (glycosylated hemoglobin A1c > 9%). The unadjusted percentage of patients with poor glycemic control was similar among Latino patients with LEP (n = 510) and Latino English-speakers (n = 2,683), and higher in both groups than in whites (n = 3,545) (21% vs 18% vs. 10%, p < 0.005). This relationship differed significantly by patient-provider language concordance (p < 0.01 for interaction). LEP patients with language-discordant physicians (n = 115) were more likely than LEP patients with language-concordant physicians (n = 137) to have poor glycemic control (27.8% vs 16.1% p = 0.02). After controlling for potential demographic and clinical confounders, LEP Latinos with language-concordant physicians had similar odds of poor glycemic control as Latino English speakers (OR 0.89; CI 0.53–1.49), whereas LEP Latinos with language-discordant physicians had greater odds of poor control than Latino English speakers (OR 1.76; CI 1.04–2.97). Among LEP Latinos, having a language discordant physician was associated with significantly poorer glycemic control (OR 1.98; CI 1.03–3.80). Language barriers contribute to health disparities among Latinos with diabetes. Limited English proficiency is an independent predictor for poor glycemic control among insured US Latinos with diabetes, an association not observed when care is provided by language-concordant physicians. Future research should determine if strategies to increase language-concordant care improve glycemic control among US Latinos with LEP.
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影响因子：
16.2
作者：
Hoerger, Thomas J.;Gregg, Edward W.;Saaddine, Jinan B.
通讯作者：
Saaddine, Jinan B.
影响因子：
3.4
作者：
Karliner, Leah S.;Jacobs, Elizabeth A.;Mutha, Sunita
通讯作者：
Mutha, Sunita
影响因子：
5.7
作者：
Gross, R;Olfson, M;Weissman, MM
通讯作者：
Weissman, MM
影响因子：
5.7
作者：
Gany, Francesca;Leng, Jennifer;Changrani, Jyotsna
通讯作者：
Changrani, Jyotsna
影响因子：
5.7
作者：
Fernandez, A;Schillinger, D;Pérez-Stable, EJ
通讯作者：
Pérez-Stable, EJ