Mosen David M, Carlson Matthew J, Morales Leo S, Hanes Pamela P
Kaiser Permanente, Care Management Institute, Portland, Oregon 97232, USA.
Ambul Pediatr. 2004 Nov-Dec;4(6):500-4. doi: 10.1367/A04-019R1.1.
To determine if differences between English- and Spanish-speaking parents in ratings of their children's health care can be explained by need for interpretive services.
Using the Consumer Assessment of Health Plans Survey-Child-Survey (CAHPS), reports about provider communication were compared among 3 groups of parents enrolled in a Medicaid managed care health plan: 1) English speakers, 2) Spanish speakers with no self-reported need for interpretive services, and 3) Spanish speakers with self-reported need for interpretive services. Parents were asked to report how well their providers 1) listened carefully to what was being said, 2) explained things in a way that could be understood, 3) respected their comments and concerns, and 4) spent enough time during medical encounters. Multivariate logistic regression was used to compare the ratings of each of the 3 groups while controlling for child's gender, parent's gender, parent's educational attainment, child's health status, and survey year.
Spanish-speaking parents in need of interpretive services were less likely to report that providers spent enough time with their children (odds ratio = 0.34, 95% confidence interval = 0.17-0.68) compared to English-speaking parents. There was no statistically significant difference found between Spanish-speaking parents with no need of interpretive services and English-speaking parents.
Among Spanish- versus English-speaking parents, differences in ratings of whether providers spent enough time with children during medical encounters appear to be explained, in part, by need for interpretive services. No other differences in ratings of provider communication were found.
确定说英语和说西班牙语的父母在对其子女医疗保健的评分上的差异是否可以通过对口译服务的需求来解释。
使用医疗保健计划消费者评估调查-儿童调查(CAHPS),对参加医疗补助管理式医疗保健计划的三组父母的医疗服务提供者沟通报告进行比较:1)说英语的父母,2)自我报告不需要口译服务的说西班牙语的父母,以及3)自我报告需要口译服务的说西班牙语的父母。父母被要求报告他们的医疗服务提供者在以下方面的表现:1)认真倾听所说内容,2)以易懂的方式解释事情,3)尊重他们的意见和关切,以及4)在医疗问诊期间花费足够的时间。在控制孩子的性别、父母的性别、父母的教育程度、孩子的健康状况和调查年份的同时,使用多变量逻辑回归来比较三组中每组的评分。
与说英语的父母相比,需要口译服务的说西班牙语的父母报告医疗服务提供者与孩子相处时间足够的可能性较小(优势比 = 0.34,95%置信区间 = 0.17 - 0.68)。在不需要口译服务的说西班牙语的父母和说英语的父母之间未发现统计学上的显著差异。
在说西班牙语和说英语的父母中,医疗问诊期间医疗服务提供者与孩子相处时间是否足够这一评分上的差异,似乎部分可以通过对口译服务的需求来解释。在医疗服务提供者沟通评分方面未发现其他差异。