Department of Health Policy & Management, Johns Hopkins University, Baltimore, MD 21205, USA.
Ethn Health. 2009 Dec;14(6):625-42. doi: 10.1080/13557850903248639.
The number of individuals with limited English proficiency in the USA is large and rapidly growing. Consequently, addressing language barriers in access to medical care is becoming increasingly important. Previous studies have reported that individuals with limited English proficiency have more difficulty gaining access to care, compared to English-proficient individuals. We assessed the impact of English language proficiency on access to medical care, accounting for health and socioeconomic status, using nationally representative data.
Cross-sectional data from the 2006 National Health Interview Survey (n=29,868). The main outcome measures of interest were self-reported delayed medical care, forgone needed care, and visits to a health care professional.
In unadjusted analyses, individuals with limited English proficiency were more likely to forgo needed medical care and less likely to have a health care visit, compared to individuals who were proficient in English. There was no significant association between language proficiency and reports of delayed care. After accounting for individuals' health and socioeconomic status, only the relationship between limited English proficiency and health care visits remained statistically significant. Most associations between language proficiency and access to care did not differ across various racial/ethnic groups.
Results indicate that the choice of access measure may influence conclusions about language barriers in health care. Given the growing proportion of US residents with limited English proficiency, health care settings need to better address potential language barriers.
美国的英语水平有限的人数众多且增长迅速。因此，解决医疗保健方面的语言障碍变得越来越重要。先前的研究报告称，与英语熟练的人相比，英语水平有限的人在获得医疗保健方面存在更多困难。我们使用全国代表性数据评估了英语水平对获得医疗保健的影响，同时考虑了健康和社会经济状况。
2006 年全国健康访谈调查的横断面数据（n=29868）。主要关注的结局指标是自我报告的医疗延迟、放弃必要的医疗保健和寻求医疗保健专业人员的就诊。
在未调整的分析中，与英语熟练的个体相比，英语水平有限的个体更有可能放弃必要的医疗保健，并且更不可能去看医疗保健专业人员。英语水平与报告的医疗延迟之间没有显著关联。在考虑到个体的健康和社会经济状况后，只有英语水平有限与医疗保健就诊之间的关系仍然具有统计学意义。语言熟练程度与获得医疗保健之间的大多数关联在不同种族/族裔群体之间没有差异。
结果表明，获得医疗保健措施的选择可能会影响有关医疗保健中语言障碍的结论。鉴于美国英语水平有限的居民比例不断增加，医疗保健机构需要更好地解决潜在的语言障碍。
