Many Hospitals Do Not Provide Translators

Many U.S. residents who do not speak English do not receive translator services at hospitals, a situation that places them at risk for medical errors or inadequate care, according to a New England Journal of Medicine perspective written by Medical College of Wisconsin-Milwaukee professor Glenn Flores, USA Today reports. Flores, an expert on language barriers in health care, based the perspective on his own studies and those conducted by other researchers.

Under Title VI of the 1964 Civil Rights Act, refusal or delay of medical care because of language barriers is considered discrimination. In addition, health care facilities that receive Medicare or Medicaid reimbursements must provide translator services to patients who have limited proficiency in English (Weise [1], USA Today, 7/20).

In 2004, the number of U.S. residents with a primary language other than English increased to almost 50 million, or 19% of the population, according to USA Today (Weise [2], USA Today, 7/20). However, according to the perspective, one recent study found that emergency departments offered no translator services in 46% of cases that involved patients who did not speak English.

The perspective also states that only 23% of teaching hospitals train physicians to work with translators.

Flores said, "Lack of interpreters translates into impaired health status, lower likelihood of being given a follow-up appointment, greater risk of hospital admissions and more drug complications" (Weise [1], USA Today, 7/20).

The trend also has led to increased health care costs and decreased quality of care, he said (Weise [2], USA Today, 7/20).

In related news, the Joint Commission on Accreditation of Healthcare Organizations has begun to analyze data from a survey of 60 hospitals nationwide to determine whether to revise standards for care and services that hospitals provide to patients who do not speak English, the AP/Kansas City Star reports. The survey examined measures taken by the hospitals to address language and cultural barriers experienced by patients who do not speak English. According to JCAHO, hospital patients with limited proficiency in English are at least three times more likely than other patients to experience medical errors.

Amy Wilson-Stronks, principal investigator of the survey, said, "If there is a large population whose needs aren't being met, I could see there being ramifications in terms of accreditation." She added that JCAHO would make any revisions to the standards for care and services that hospitals provide to patients who do not speak English "in a manner that's not overly burdensome to an organization" (Burke, AP/Kansas City Star, 7/19).