Fagan Mark J, Diaz Joseph A, Reinert Steven E, Sciamanna Christopher N, Fagan Dylan M
Division of General Internal Medicine, Department of Medicine, Brown Medical School, Providence, RI, USA.
J Gen Intern Med. 2003 Aug;18(8):634-8. doi: 10.1046/j.1525-1497.2003.20701.x.
To determine the impact of interpretation method on outpatient visit length.
Time-motion study.
Hospital-based outpatient teaching clinic.
Patients presenting for scheduled outpatient visits.
Over a 6-week study period, a research assistant recorded the following information for consecutive patient visits: patient age, gender and insurance type; type of interpreter used (none, hospital interpreter, telephone interpreter or patient-supplied interpreter); scheduled visit length; provider type (nurse practitioner; attending physician; resident in postgraduate year 1, 2 or 3, or medical student); provider gender; amount of time the patient spent in the examination room with the provider (provider time); and total time the patient spent in the clinic from check-in to checkout (clinic time). When compared to patients not requiring an interpreter, patients using some form of interpreter had longer mean provider times (32.4 minutes [min] vs 28.0 min, P <.001) and clinic times (93.6 min vs 82.4 min, P =.002). Compared to patients not requiring an interpreter, patients using a telephone interpreter had significantly longer mean provider times (36.3 min vs 28.0 min, P <.001) and clinic times (99.9 min vs 82.4 min, P =.02). Similarly, patients using a patient-supplied interpreter had longer mean provider times (34.4 min vs 28.0 min, P <.001) and mean clinic times (92.8 min vs 82.4 min, P =.027). In contrast, patients using a hospital interpreter did not have significantly different mean provider times (26.8 min vs 28.0 min, P =.51) or mean clinic times (91.0 min vs 82.4 min, P =.16) than patients not requiring an interpreter.
In our setting, telephone and patient-supplied interpreters were associated with longer visit times, but full-time hospital interpreters were not.
确定口译方式对门诊就诊时长的影响。
时间动作研究。
医院门诊教学诊所。
前来进行预约门诊就诊的患者。
在为期6周的研究期间，一名研究助理记录了连续患者就诊的以下信息：患者年龄、性别和保险类型；所使用的口译员类型（无、医院口译员、电话口译员或患者自带口译员）；预约就诊时长；提供者类型（执业护士、主治医师、研究生一年级、二年级或三年级住院医师或医学生）；提供者性别；患者与提供者在检查室花费的时间（提供者时间）；以及患者从登记到结账在诊所花费的总时间（诊所时间）。与不需要口译员的患者相比，使用某种形式口译员的患者平均提供者时间更长（32.4分钟[min]对28.0分钟，P<.001），诊所时间也更长（93.6分钟对82.4分钟，P=.002）。与不需要口译员的患者相比，使用电话口译员的患者平均提供者时间显著更长（36.3分钟对28.0分钟，P<.001），诊所时间也更长（99.9分钟对82.4分钟，P=.02）。同样，使用患者自带口译员的患者平均提供者时间更长（34.4分钟对28.0分钟，P<.001），平均诊所时间也更长（92.8分钟对82.4分钟，P=.027）。相比之下，使用医院口译员的患者与不需要口译员的患者相比，平均提供者时间（26.8分钟对28.0分钟，P=.51）或平均诊所时间（91.0分钟对82.4分钟，P=.16）没有显著差异。
在我们的研究环境中，电话口译员和患者自带口译员与就诊时间延长有关，但全职医院口译员则不然。
