Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Center for Healthcare Advancement and Outcomes, Miami Cardiac and Vascular Institute, Baptist Health South Florida, Miami, FL, USA.
Surgery. 2018 Jun;163(6):1220-1225. doi: 10.1016/j.surg.2018.01.012. Epub 2018 Feb 23.
The number of patients in the United States (US) who speak a language other than English is increasing. We evaluated the impact of English proficiency on self-reported patient-provider communication and shared decision-making.
The 2013-2014 Medical Expenditure Panel Survey database was utilized to identify respondents who spoke a language other than English. Patient-provider communication (PPC) and shared decision-making (SDM) scores from 4-12 were categorized as "poor" (4-7), "average" (8-11), and "optimal." The relationship between PPC, SDM, and English proficiency was analyzed.
Among 13,880 respondents, most were white (n = 10,281, 75%), age 18-39 (n = 6,677, 48%), male (n = 7,275, 52%), middle income (n = 4,125, 30%), and born outside of the US (n = 9,125, 65%). English proficiency was rated as "very well" (n = 7,221, 52%), "well" (n = 2,378, 17%), "not well" (n = 2,820, 20%), or "not at all" (n = 1,463, 10%). On multivariable analysis, patients who rated their English as "well" (OR 1.73, 95% CI 1.37-2.18) or "not well" (OR 1.53, 95% CI 1.10-2.14) were more likely to report "poor" PPC (both P < .01). Similarly, SDM was more commonly self-reported as "poor" among patients who reported English proficiency as "not well" (OR 1.31, 95% CI 1.04-1.65, P = .02).
Decreased English proficiency was associated with worse self-reported patient-provider communication and shared decision-making. Attention to patients' language needs is critical to patient satisfaction and improved perception of care.
美国（US）讲英语以外语言的患者人数正在增加。我们评估了英语水平对患者-提供者沟通和共同决策的影响。
利用 2013-2014 年医疗支出面板调查数据库，确定讲英语以外语言的受访者。4-12 分的患者-提供者沟通（PPC）和共同决策（SDM）评分被归类为“差”（4-7）、“一般”（8-11）和“最佳”。分析了 PPC、SDM 与英语水平之间的关系。
在 13880 名受访者中，大多数是白人（n=10281，75%）、年龄 18-39 岁（n=6677，48%）、男性（n=7275，52%）、中等收入（n=4125，30%）和出生于美国境外（n=9125，65%）。英语水平被评为“非常好”（n=7221，52%）、“好”（n=2378，17%）、“不好”（n=2820，20%）或“一点也不好”（n=1463，10%）。在多变量分析中，自评英语“好”（比值比 1.73，95%置信区间 1.37-2.18）或“不好”（比值比 1.53，95%置信区间 1.10-2.14）的患者更有可能报告“差”的 PPC（均 P<0.01）。同样，报告英语水平“不好”的患者中，SDM 更常被自我报告为“差”（比值比 1.31，95%置信区间 1.04-1.65，P=0.02）。
英语水平下降与自我报告的患者-提供者沟通和共同决策较差相关。关注患者的语言需求对于患者满意度和改善护理认知至关重要。
