Skip to main content
Log in

Effect of language barriers on follow-up appointments after an emergency department visit

  • Populations At Risk
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

OBJECTIVE: To determine whether patients who encountered language barriers during an emergency department visit were less likely to be referred for a follow-up appointment and less likely to complete a recommended appointment.

DESIGN: Cohort study.

SETTING: Public hospital emergency department.

PARTICIPANTS: English- and Spanish-speaking patients (N=714) presenting with nonemergent medical problems.

MEASUREMENTS AND MAIN RESULTS: Patients were interviewed to determine sociodemographic information, health status, whether an interpreter was used, and whether an interpreter should have been used. The dependent variables were referral for a follow-up appointment after the emergency department visit and appointment compliance, as determined by chart review and the hospital information system. The proportion of patients who received a follow-up appointment was 83% for those without language barriers, 75% for those who communicated through an interpreter, and 76% for those who said an interpreter should have been used but was not (P=.05). In multivariate analysis, the adjusted odds ratio for not receiving a follow-up appointment was 1.92 (95% confidence interval [CI], 1.11 to 3.33) for patients who had an interpreter and 1.79 (95% CI, 1.00 to 3.23) for patients who said an interpreter should have been used (compared with patients without language barriers). Appointment compliance rates were similar for patients who communicated through an interpreter, those who said an interpreter should have been used but was not, and those without language barriers (60%, 54%, and 64%, respectively; P=.78).

CONCLUSIONS: Language barriers may decrease the likelihood that a patient is given a follow-up appointment after an emergency department visit. However, patients who experienced language barriers were equally likely to comply with follow-up appointments.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Treviño FM, Moyer ME, Valdex RB, Stroup-Benham CA. Health insurance coverage and utilization of health services by Mexican American, mainland Puerto Ricans, and Cuban Americans. JAMA. 1991;265:233–7.

    Article  PubMed  Google Scholar 

  2. Hough RL, Landsverk JA, Karno M, et al. Utilization of health and mental services by Los Angeles Mexican Americans and non-Hispanic whites. Arch Gen Psychiatry. 1987;44:702–9.

    PubMed  CAS  Google Scholar 

  3. Valdez RB, Morgenstern H, Brown ER, Wyn R, Wang C, Cumberland W. Insuring Latinos against the cost of illness. JAMA. 1993;269:889–94.

    Article  PubMed  CAS  Google Scholar 

  4. Andersen R, Lewis SZ, Giachello AL, Aday LA, Chiu G. Access to medical care among the Hispanic population of the Southwestern United States. J Health Soc Behav. 1981;22:78–89.

    Article  PubMed  CAS  Google Scholar 

  5. Gany F, De Bocanegra HT. Overcoming barriers to improving the health of immigrant women. J Am Med Womens Assoc. 1996;51:155–60.

    PubMed  CAS  Google Scholar 

  6. Valdez RB, Giachello AL, Rodriquez-Trias H, Gomez P, De la Rocha C. Improving access to health care in Latino communities. Public Health Rep. 1993;108:534–9.

    PubMed  CAS  Google Scholar 

  7. Andersen R, Giachello AL, Aday LA. Access of Hispanics to health care and cuts in services: a state-of-the-art overview. Public Health Rep. 1986;101:238–52.

    PubMed  CAS  Google Scholar 

  8. Pitkin K, Baker DW. Limited English proficiency and Latinos’ use of physician services. Med Care Res Rev. In press.

  9. Schur CL, Albers LA, Berk ML. Health care use by Hispanic adults: financial vs. non-financial determinants. Health Care Financing Rev. 1995;17:71–88.

    CAS  Google Scholar 

  10. Baker DW, Hayes R, Puebla-Fortier J. Interpreter use and satisfaction with interpersonal aspects of care for Spanish-speaking patients. Med Care. 1998;36:1461–70.

    Article  PubMed  CAS  Google Scholar 

  11. Carrasquillo O, Orav EJ, Brennan TA, Burstin HR. Impact of language barriers on patient satisfaction in an emergency department. J Gen Intern Med. 1999;14:82–7.

    Article  PubMed  CAS  Google Scholar 

  12. Todd KH, Samaroo N, Hoffman JR. Ethnicity as a risk factor for inadequate emergency department analgesia. JAMA. 1993;269:1537–9.

    Article  PubMed  CAS  Google Scholar 

  13. Manson A. Language concordance as a determinant of patient compliance and emergency room use in patients with asthma. Med Care. 1988;26:1119–28.

    Article  PubMed  CAS  Google Scholar 

  14. Parker RM, Baker DW, Williams MV, Nurss JR. The Test of Functional Health Literacy in Adults (TOFHLA): a new instrument for measuring patients’ literacy skills. J Gen Intern Med. 1995;10:537–41.

    PubMed  CAS  Google Scholar 

  15. Magnusson AR, Hedges JR, Vanko M, McCarten K, Moorhead JC. Follow-up compliance after emergency department evaluation. Ann Emerg Med. 1992;22:560–7.

    Article  Google Scholar 

  16. Todd KH, Lee T, Hoffman JR. The effect of ethnicity on physician estimates of pain severity in patients with isolated extremity trauma. JAMA. 1994;274:925–8.

    Article  Google Scholar 

  17. Cleeland CS, Gonin R, Baez L, Loehrer P, Pandya KJ. Pain and treatment of pain in minority patients with cancer: The Eastern Cooperative Oncology Group Minority Outpatient Pain Study. Ann Intern Med. 1997;127:813–6.

    PubMed  CAS  Google Scholar 

  18. Ziv TA, Lo B. Denial of care to illegal immigrants: Proposition 187 in California. N Engl J Med. 1995;332:1095–8.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David W. Baker MD, MPH.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sarver, J., Baker, D.W. Effect of language barriers on follow-up appointments after an emergency department visit. J GEN INTERN MED 15, 256–264 (2000). https://doi.org/10.1111/j.1525-1497.2000.06469.x

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1111/j.1525-1497.2000.06469.x

Key words

Navigation