Is Primary Care Patient Experience Associated with Provider-Patient Language Concordance and Use of Interpreters for Spanish-preferring Patients: A Systematic Literature Review

Denise D Quigley; Nabeel Qureshi; Zachary Predmore; Yareliz Diaz; Ron D Hays

doi:10.1007/s40615-024-01951-z

Is Primary Care Patient Experience Associated with Provider-Patient Language Concordance and Use of Interpreters for Spanish-preferring Patients: A Systematic Literature Review

J Racial Ethn Health Disparities. 2024 Mar 5. doi: 10.1007/s40615-024-01951-z. Online ahead of print.

Authors

Denise D Quigley¹, Nabeel Qureshi², Zachary Predmore³, Yareliz Diaz³, Ron D Hays^{2

4}

Affiliations

¹ RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA. quigley@rand.org.
² RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA.
³ RAND Corporation, 20 Park Plaza, Suite 910, Boston, MA, USA.
⁴ David Geffen School of Medicine & Department of Medicine, UCLA, 1100 Glendon Avenue, Los Angeles, CA, 90024-1736, USA.

PMID: 38441859
DOI: 10.1007/s40615-024-01951-z

Abstract

Background: Healthcare provided by a bilingual provider or with the assistance of an interpreter improves care quality; however, their associations with patient experience are unknown. We reviewed associations of patient experience with provider-patient language concordance (LC) and use of interpreters for Spanish-preferring patients.

Method: We reviewed articles from academic databases 2005-2023 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Joanna Briggs Institute Checklists to rate study quality. We reviewed 217 (of 2193) articles, yielding 17 for inclusion.

Results: Of the 17 included articles, most articles focused on primary (n = 6 studies) or pediatric care (n = 5). All were cross-sectional, collecting data by self-administered surveys (n = 7) or interviews (n = 4). Most assessed the relationship between LC or interpreter use and patient experience by cross-sectional associations (n = 13). Two compared subgroups, and two provided descriptive insights into the conversational content (provider-interpreter-patient). None evaluated interventions, so evidence on effective strategies is lacking. LC for Spanish-preferring patients was a mix of null findings (n = 4) and associations with better patient experience (n = 3) (e.g., receiving diet/exercise counseling and better provider communication). Evidence on interpreter use indicated better (n = 2), worse (n = 2), and no association (n = 2) with patient experience. Associations between Spanish-language preference and patient experience were not significant (n = 5) or indicated worse experience (n = 4) (e.g., long waits, problems getting appointments, and not understanding nurses).

Conclusion: LC is associated with better patient experience. Using interpreters is associated with better patient experience but only with high-quality interpreters. Strategies are needed to eliminate disparities and enhance communication for all Spanish-preferring primary care patients, whether with a bilingual provider or an interpreter.

Keywords: Clinician and group CAHPS survey; Patient experience; Primary care; Quality of care.

Abstract

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