Navigating Healthcare with Limited English Proficiency

With reduced barriers to seeking out a language-concordant provider, we examined associations of patient language and patient-provider language concordance (i.e., speaking the same language) with telemedicine visit type (video or phone visit). Compared to patients speaking Spanish, video visit use was higher among patients speaking Cantonese, Mandarin, and Vietnamese, but lower among those speaking Punjabi. Interestingly, video visit use was lower among those who shared the same language as their provider. It’s possible that those who do not speak the same language as their provider rely on the visual cues video visits afford.

Healthcare systems strive to provide language-concordant care, but does it result in better patient outcomes? We synthesized 38 studies assessing the relationships of patient-provider language concordance (i.e., speaking the same language) with global health outcomes (patient behaviors, provider behaviors, interpersonal processes of care, and clinical outcomes) among those with limited English proficiency. Most studies used a cross-sectional design, recruited Spanish speakers, and focused on physician healthcare providers. While findings were split between favoring language-concordant care and detecting no association, significant methodological limitations dampen our confidence in results. To address these findings and limitations, we present an evidence map, research agenda, and identify knowledge gaps to promote the enhancement of future research and raise awareness of the implications of patient-provider language concordance.