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Language Impacts Patient Health Outcomes, Not Only Patient Satisfaction

Interpretation improves the patient experience for non-English speakers but also has the potential to make a meaningful difference to the success of their treatment, as one recent study of patient outcomes during the COVID-19 pandemic reveals.

The differences in patient experience between white and minority communities came to the forefront during the COVID-19 pandemic. Data revealed that minority communities were not only more likely to catch COVID-19, but they were also more likely to experience severe outcomes from infection, including higher death rates. 

Understandably, communities, governments, and healthcare providers wanted to know why this could be. For example, was it down to a higher prevalence of pre-existing health conditions, greater exposure to infection, or a reflection of social inequalities, such as confined living spaces or reduced access to healthcare?

While ethnicity has been linked to certain risk factors (such as the likelihood of pre-existing conditions), many experts—including the United Nations—believe that COVID-19 has simply exposed existing inequalities within society. In other words, minority communities are at higher risk because of socio-economic factors that could otherwise be improved and controlled. 

Language Matters More Than You Might Think

For ‘Is the Gap Closing? Comparison of Sociodemographic Disparities in COVID-19 Hospitalizations and Outcomes Between Two Temporal Waves of Admissions’, published in February 2022, the outcome of primary care patients that were hospitalized with COVID-19 was studied in one healthcare system in two six-month waves between March 1, 2020, and March 1, 2021. 

By comparing ethnicity and language with severe in-hospital outcomes (death, hospice discharge, intensive care), the authors wanted to understand what difference had been made—if any—by interventions and policies that had been implemented between the two waves.

Its data found that wave 1 patients originated predominately from highly socially vulnerable neighborhoods, with racial/ethnic minority and non-English-speaking patients very disproportionately represented among COVID-19 admissions compared to pre-pandemic rates. 

Perhaps more strikingly, the study also found non-English-speaking status to “significantly and independently predict severe illness,” with limited-English proficiency (LEP) associated with “35% higher odds of severe illness outcomes including death” during wave 1. 

There are several important reasons for this, as discussed in the study. In particular:

  • Language barriers can lead to delays in clinical presentation: For example, non-English-speaking individuals may be less aware of how to navigate the US health system, have limited access to translations of healthcare materials or public health announcements, or be less willing to visit hospitals in general. Indeed, the study found that the proportion of admitted non-English-speaking patients increased fourfold from pre-pandemic rates, which suggests that many patients were navigating the system for the first time. 
  • LEP patients may experience suboptimal care: The study found that the ability of non-English-speaking patients to communicate symptoms or provide relevant history was further impacted by COVID-19 infection control policies, such as mask-wearing and isolation policies. In particular, in-person interpreter access was limited by isolation rules, while COVID-19 respiratory symptoms and mask-wearing made phone-based interpretation more challenging.

Mass General Brigham (the healthcare system in the study) responded with additional targeted strategies to support LEP inpatients after the first wave. These included increasing in-person interpreter availability for non-Spanish languages, investing in video-based interpretation equipment for isolation rooms, and using signs to remind staff of patients’ preferred languages.

Even though inpatient numbers still remained skewed toward minority and immigrant populations during the second wave, the study found that language was no longer a significant predictor of a poor outcome, reinforcing the importance and potential impact of such language access interventions.

Get Started with Healthcare Interpretation Today!

Professional interpretation can help your healthcare facility improve the patient experience for its limited-English proficient speakers, increasing patient satisfaction and even promoting positive outcomes. Contact us today to discover how our services can satisfy your interpretation needs.

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