Garcia Maria E, Bindman Andrew B, Coffman Janet
Division of General Internal Medicine, Department of Medicine, University of California at San Francisco (UCSF), San Francisco, California.
Philip R. Lee Institute for Health Policy Studies, University of California at San Francisco (UCSF), San Francisco, California.
Health Equity. 2019 Jul 1;3(1):343-349. doi: 10.1089/heq.2019.0035. eCollection 2019.
The population with limited English proficiency (LEP) in California is growing. We sought to determine whether enough primary care physicians (PCPs) have the language skills to meet patient needs. The authors determined the number of PCPs who self-report proficiency in the five most common non-English languages spoken in California (Spanish, Cantonese, Mandarin, Tagalog, and Vietnamese) using Medical Board of California data from 2013 to 2015. The authors estimated LEP populations during 2011-2015 using Census data. They calculated PCP supply (the ratio of PCPs/100,000 LEP individuals) compared to a federal standard to judge adequacy. They performed a sensitivity analysis adjusting the percentage of LEP patients in a bilingual physicians' practice from 100% to the percentage of LEP individuals in California who spoke that language. Of 19,310 PCPs in California, 15,933 (83%) provided information about languages they speak. There were 5,203 (33%) Spanish-, 486 (3%) Cantonese-, 986 (6%) Mandarin-, 956 (6%) Tagalog-, and 671 (4%) Vietnamese-speaking PCPs. PCP supply, compared to a federal standard, was adequate if we assumed that bilingual PCPs only care for LEP patients. However, if one assumes the number of LEP patients in a PCP's practice reflects the percentage in the general population, there is a large PCP undersupply for all languages. Estimates of access to language-concordant PCPs for LEP individuals are sensitive to assumptions about the percentage of LEP patients in a PCP's panel. Ensuring language-concordant access will require deliberate effort to match LEP patients with bilingual PCPs.
加利福尼亚州英语水平有限（LEP）的人口正在增长。我们试图确定是否有足够多的初级保健医生（PCP）具备满足患者需求的语言技能。作者利用2013年至2015年加利福尼亚州医疗委员会的数据，确定了自我报告精通加利福尼亚州五种最常用非英语语言（西班牙语、粤语、普通话、他加禄语和越南语）的初级保健医生的数量。作者使用人口普查数据估算了2011年至2015年期间的LEP人口。他们将初级保健医生的供给量（每10万名LEP个体对应的初级保健医生数量）与联邦标准进行比较，以判断供给是否充足。他们进行了敏感性分析，将双语医生诊所中LEP患者的比例从100%调整为加利福尼亚州说该语言的LEP个体的比例。在加利福尼亚州的19310名初级保健医生中，15933名（83%）提供了他们所讲语言的信息。有5203名（33%）说西班牙语、486名（3%）说粤语、986名（6%）说普通话、956名（6%）说他加禄语以及671名（4%）说越南语的初级保健医生。与联邦标准相比，如果假设双语初级保健医生只照顾LEP患者，那么初级保健医生的供给是充足的。然而，如果假设初级保健医生诊所中LEP患者的数量反映了总体人口中的比例，那么所有语言的初级保健医生都存在大量供应不足的情况。对于LEP个体获得语言匹配的初级保健医生的估计，对关于初级保健医生患者群体中LEP患者比例的假设很敏感。确保语言匹配的就医机会将需要刻意努力，以使LEP患者与双语初级保健医生相匹配。
