Med
Care 1988 Dec;26(12):1119-28.
Language concordance as a determinant of patient compliance and emergency
room use in patients with asthma.
Manson A.
Division of General Medicine, Presbyterian Hospital, New York, NY 10032.
To test the hypothesis that the ability of physicians to speak the same
language as asthmatic patients promotes patient compliance and the use
of scheduled office appointments in preference to emergency services,
the charts of 96 Spanish-speaking patients with asthma were reviewed.
Of these patients, 65 were cared for by seven Spanish-speaking bilingual
physicians and 31 were cared for by 23 non-Spanish speaking physicians.
Compared with patients with language concordant physicians, patients with
language discordant physicians were only slightly more likely to omit
medication, to miss office appointments, and to make at least one emergency
room visit. Subgroup analysis showed that, with extended follow-up, patients
cared for by a language discordant physician were more likely to omit
medication (rate ratio: 3.24; p = 0.08), more likely to miss office appointments
(rate ratio: 3.06; P = 0.01), and were slightly more likely to make an
emergency room visit (rate ratio: 2.07; P = 0.12) than patients with language
concordant physicians. Cox regression analyses taking account of differences
in follow-up time, age, gender, pay-status, and severity of disease confirmed
these findings. These data suggest that patient compliance and more cost-effective
use of ambulatory care services may be associated with the ability of
physicians to speak the same language as their patients.
PMID: 3199910 [PubMed - indexed for MEDLINE]