Office of Women's Health, Mayo Clinic, Rochester, MN 55905, USA.
J Gen Intern Med. 2013 Mar;28(3):386-91. doi: 10.1007/s11606-012-2159-5. Epub 2012 Jul 11.
Patients requiring interpreters may utilize the health care system differently or more frequently than patients not requiring interpreters; those with mental health issues may be particularly difficult to diagnose.
To determine whether adult patients requiring interpreters exhibit different health care utilization patterns and rates of mental health diagnoses than their counterparts.
Retrospective cohort study examining patient visits to primary care (PC), express care (EC), or the emergency department (ED) of a large group practice within 1 year.
Adult outpatients (n = 63,525) with at least one visit within the study interval and information regarding interpreter need.
Mean visit counts, counts of mental disorders, and somatic symptom diagnoses between patients requiring interpreters (IS patients) and not requiring interpreters (non-IS patients).
IS patients (n = 1,566) had a higher mean number of visits overall (3.10 vs. 2.52), in PC (2.54 vs. 1.95), and in ED (0.53 vs. 0.44) than non-IS patients (all p < 0.01). IS patients had a lower mean number of visits in EC than non-IS patients (0.03 vs. 0.13; p < 0.01). Interpreter need remained a significant predictor of visit count in multivariate analyses including age, sex, insurance, and clinical complexity. A greater proportion of IS patients were high utilizers (10+ visits) than non-IS patients (3.6 % vs. 1.7 %; p < 0.01). IS patients had a lower frequency of mental health diagnoses (13.9 % vs. 16.7 %), but a higher frequency of diagnoses recognized as potential somatic symptoms including diseases of the nervous (29.3 % vs. 24.2 %), digestive (22.6 % vs. 14.5 %), and musculoskeletal systems (43.2 % vs. 34.5 %), and ill-defined conditions (61 % vs. 49.9 %), all p < 0.01.
IS patients visited PC more often than their counterparts and were more often high utilizers of care. Two sources of high utilization, mental health diagnoses and somatic symptoms, differed appreciably between our populations and may be contributing factors.
需要口译员的患者可能比不需要口译员的患者在使用医疗保健系统方面存在差异或更频繁；有心理健康问题的患者可能更难诊断。
确定需要口译员的成年患者与他们的同龄人相比，是否存在不同的医疗保健利用模式和心理健康诊断率。
对大型实践群体在 1 年内进行的初级保健（PC）、快速护理（EC）或急诊部（ED）患者就诊的回顾性队列研究。
在研究期间至少有一次就诊且有口译需求的成年门诊患者（n=63525）。
需要口译员的患者（IS 患者）和不需要口译员的患者（非 IS 患者）之间的平均就诊次数、精神障碍次数和躯体症状诊断次数。
IS 患者（n=1566）的总就诊次数（3.10 次比 2.52 次）、PC 就诊次数（2.54 次比 1.95 次）和 ED 就诊次数（0.53 次比 0.44 次）均高于非 IS 患者（均 P<0.01）。IS 患者在 EC 的就诊次数低于非 IS 患者（0.03 次比 0.13 次；P<0.01）。在包括年龄、性别、保险和临床复杂性的多变量分析中，口译需求仍然是就诊次数的显著预测因素。与非 IS 患者相比，更多的 IS 患者为高利用率患者（就诊 10 次以上）（3.6%比 1.7%；P<0.01）。IS 患者的心理健康诊断率较低（13.9%比 16.7%），但被识别为潜在躯体症状的诊断率较高，包括神经系统疾病（29.3%比 24.2%）、消化系统疾病（22.6%比 14.5%）和肌肉骨骼系统疾病（43.2%比 34.5%）以及定义不明确的疾病（61%比 49.9%），均 P<0.01。
IS 患者比他们的同龄人更频繁地就诊于 PC，并且更经常成为医疗保健的高利用率者。高利用率的两个来源，心理健康诊断和躯体症状，在我们的人群中存在明显差异，可能是促成因素。
