Do Professional Interpreters Improve Clinical Care for Patients with Limited English Proficiency? A Systematic Review of the Literature

Authors

  • Leah S. Karliner,

    1. Division of General Internal Medicine, Medical Effectiveness Research Center for Diverse Populations, Department of Medicine, University of California, San Francisco, 1701 Divisadero, Suite 500, San Franicsco, CA 94143-1732,
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    • Address correspondence to Leah S. Karliner, M.D., M.A.S, Assistant Professor of Medicine, Division of General Internal Medicine, Medical Effectiveness Research Center for Diverse Populations, Department of Medicine, University of California, San Francisco, 1701 Divisadero, Suite 500, San Franicsco, CA 94143-1732. Elizabeth A. Jacobs, M.D. M.P.P, Assistant Professor of Medicine, is with the Collaborative Research Unit, Cook County Hospital & Rush Medical College, Chicago, IL. Alice Hm Chen, M.D., Assistant Professor of Medicine, Director, is with the General Medicine Clinic, San Francisco General Hospital, Department of Medicine, University of California, San Francisco, CA. Sunita Mutha, M.D., Associate Professor of Medicine, is with the Department of Medicine, The Center for Health Professions, University of California, San Francisco, CA.

  • Elizabeth A. Jacobs,

    1. Collaborative Research Unit, Cook County Hospital & Rush Medical College, Chicago, IL,
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  • Alice Hm Chen,

    1. General Medicine Clinic, San Francisco General Hospital, Department of Medicine, University of California, San Francisco, CA,
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  • Sunita Mutha

    1. Department of Medicine, The Center for Health Professions, University of California, San Francisco, CA
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Abstract

Objective. To determine if professional medical interpreters have a positive impact on clinical care for limited English proficiency (LEP) patients.

Data Sources. A systematic literature search, limited to the English language, in PubMed and PsycINFO for publications between 1966 and September 2005, and a search of the Cochrane Library.

Study Design. Any peer-reviewed article which compared at least two language groups, and contained data about professional medical interpreters and addressed communication (errors and comprehension), utilization, clinical outcomes, or satisfaction were included. Of 3,698 references, 28 were found by multiple reviewers to meet inclusion criteria and, of these, 21 assessed professional interpreters separately from ad hoc interpreters. Data were abstracted from each article by two reviewers. Data were collected on the study design, size, comparison groups, analytic technique, interpreter training, and method of determining the participants' need for an interpreter. Each study was evaluated for the effect of interpreter use on four clinical topics that were most likely to either impact or reflect disparities in health and health care.

Principal Findings. In all four areas examined, use of professional interpreters is associated with improved clinical care more than is use of ad hoc interpreters, and professional interpreters appear to raise the quality of clinical care for LEP patients to approach or equal that for patients without language barriers.

Conclusions. Published studies report positive benefits of professional interpreters on communication (errors and comprehension), utilization, clinical outcomes and satisfaction with care.

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