English-Language Competency Using Written Tests of Health Literacy

INTRODUCTION

Hispanics are the fastest-growing minority in America. The rise in minority populations, many of whom do not speak English, demands that healthcare institutions be able to communicate with these persons. The Office of Health and Human Services (HHS), Office of Civil Rights defines people with limited English proficiency (LEP) as those who cannot speak, read, write or understand English at a level that permits them to interact effectively with healthcare providers. HHS believes that LEP persons are often excluded from programs and experience delay or denial of healthcare services based on inaccurate or incomplete information.

The clinical consequences of inadequate communication by LEP persons include impairment of the exchange of information from patient to physician, communication from physician to patient, and ethi­cal concerns. The physician has a duty to perform a proper medical examination; his failure to do so can constitute negligence if the patient suffers some harm attributable to this failure, including the inaccuracy or incompleteness of a history obtained across a language barrier. In a study of the impact of barriers in an emergency department (ED), Car-rasquillo found that non-English speakers were less satisfied with their care and less likely to return to the same ED. Rosen, Sanford and Scott found that the most commonly perceived problem in caring for Spanish-speaking patients in the ED was a failure on the part of the medical staff to fully appreciate the presenting complaints.

Physicians frequently and informally determine a Hispanic patient’s ability and willingness to speak English. It is just as often questionable whether self-declared English-speaking patients possess the ability necessary to communicate in English. The primary purpose of this study was to test English-language competency of self-declared English-speaking Hispanic patients in the ED. The secondary purpose was to determine the concordance of the testing to the healthcare providers’ assessment of the patients’ English-language ability.

Category: Health

Tags: English-language competency, interpreters