First Advisor

Sharon M. Lee

Term of Graduation

Fall 2000

Date of Publication

10-30-2000

Document Type

Thesis

Degree Name

Master of Science (M.S.) in Sociology

Department

Sociology

Language

English

Subjects

Health facilities -- Translating services -- United States, Linguistic minorities -- Medical care -- United States, Transcultural medical care -- United States

Physical Description

1 online resource (iv, 76 pages)

Abstract

Due largely to immigration, a growing proportion of the U.S. population does not speak English well enough to communicate with medical providers. Many research studies have described ways in which language differences can compromise health care quality and access for language minority groups, but professional interpreter services are rarely provided due to costs of services and to increasing cultural and linguistic diversity among patients with limited English proficiency (LEP). Some researchers have argued that costs of interpreter services could be offset through enabling LEP patients to maintain better health and use health services more cost-effectively, such as obtaining care in routine primary and preventive care visits rather than in emergency rooms.

To assess the diversity of the LEP population of a large health maintenance organization (HMO) and to evaluate some effects of an interpreter services program on these patients' visit patterns, administrative and clinical data from the HMO and its interpreter services contractor were merged to identify LEP patients with four years of continuous health plan coverage. Andersen's behavioral model of health care utilization was used as a conceptual framework. Visit data for 1,037 LEP patients were analyzed for two years before and two years after initiation of an interpreter services program. Generic control measures obtained from the HMO's annual Health Plan Employer Data Information Set (HEDIS®) reports were used to compare the LEP patient sample to the overall patient population. Intensity of use of the interpreter services program and demographic characteristics also were evaluated.

The study found a large amount of language diversity and partial utilization of the interpreter services program within the LEP study group. For the 54 7 patients whose average visit rates initially were much lower than the average of the HMO's overall population, the rate of routine visits increased significantly in the two years after interpreter services were made available. Rather than decreasing, the average rate of emergency room visits for these patients did not change significantly, but the ratio of routine visits to emergency visits increased, suggesting reduced reliance on emergency services. Implications for further research are discussed.

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