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      Access to Healthcare Interpreter Services: Where Are We and Where Do We Need to Go?

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          Abstract

          Due to international migration, health care professionals in Switzerland increasingly encounter language barriers in communication with their patients. In order to examine health professionals’ attitudes and practices related to healthcare interpreting, we sent a self-administered questionnaire to heads of medical and nursing departments in public healthcare services in the canton of Basel-Stadt (N = 205, response rate 56%). Strategies used to communicate with foreign-language speaking patients differed, depending on the patient’s language. While nearly half of respondents relied on patients’ relatives to translate for Albanian, Tamil, Bosnian, Croatian, Serbian, Portuguese and Turkish, a third did so for Spanish, and a fourth did so for Arabic. Eleven percent relied on professional interpreters for Spanish and 31% did so for Tamil and Arabic. Variations in strategies used appear to mainly reflect the availability of bilingual staff members for the different languages. Future efforts should focus on sensitizing health professionals to the problems associated with use of ad hoc interpreters, as well as facilitating access to professional interpreters.

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          Immigrants and health care: sources of vulnerability.

          Kathryn Derose, José J. Escarce, Nicole Lurie (2015)
          Immigrants have been identified as a vulnerable population, but there is heterogeneity in the degree to which they are vulnerable to inadequate health care. Here we examine the factors that affect immigrants' vulnerability, including socioeconomic background; immigration status; limited English proficiency; federal, state, and local policies on access to publicly funded health care; residential location; and stigma and marginalization. We find that, overall, immigrants have lower rates of health insurance, use less health care, and receive lower quality of care than U.S.-born populations; however, there are differences among subgroups. We conclude with policy options for addressing immigrants' vulnerabilities.
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            Pregnancy outcome of migrant women and integration policy: a systematic review of the international literature.

            Paola Bollini, Sandro Pampallona, Philippe Wanner … (2009)
            Immigrant mothers in developed countries often experience worse pregnancy outcomes than native women. Several epidemiological studies have described the pregnancy outcome of immigrant women in European receiving countries, with conflicting results. The present systematic review makes a quantitative synthesis of available evidence on the association between pregnancy outcomes and integration policies. We reviewed all epidemiological studies comparing the pregnancy outcome of native versus immigrant women in European countries from 1966 to 2004 and retained 65 for analysis, from 12 host countries. Overall, as compared to native women, immigrant women showed a clear disadvantage for all the outcomes considered: 43% higher risk of low birth weight, 24% of pre-term delivery, 50% of perinatal mortality, and 61% of congenital malformations. The risks were clearly and significantly reduced in countries with a strong integration policy. This trend was maintained even after adjustment for age at delivery and parity. On the basis of an analysis of naturalisation rates, five countries in our sample could be categorised as having a strong policies promoting the integration of immigrant communities. The mechanisms through which integration policies may be protective include the increased participation of immigrant communities in the life of the receiving society, and the decreased stress and discrimination they may face. The results of this study highlight a serious problem of equity in perinatal health across European countries. Immigrant women clearly need targeted attention to improve the health of their newborn, but a deep societal change is also necessary to integrate and respect immigrant communities in receiving societies.
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              Getting by: underuse of interpreters by resident physicians.

              Leslie A Curry, Scott Diamond, Elizabeth H Bradley … (2009)
              Language barriers complicate physician-patient communication and adversely affect healthcare quality. Research suggests that physicians underuse interpreters despite evidence of benefits and even when services are readily available. The reasons underlying the underuse of interpreters are poorly understood. To understand the decision-making process of resident physicians when communicating with patients with limited English proficiency (LEP). Qualitative study using in-depth interviews. Internal medicine resident physicians (n = 20) from two urban teaching hospitals with excellent interpreter services. An interview guide was used to explore decision making about interpreter use. Four recurrent themes emerged: 1) Resident physicians recognized that they underused professional interpreters, and described this phenomenon as "getting by;" 2) Resident physicians made decisions about interpreter use by weighing the perceived value of communication in clinical decision making against their own time constraints; 3) The decision to call an interpreter could be preempted by the convenience of using family members or the resident physician's use of his/her own second language skills; 4) Resident physicians normalized the underuse of professional interpreters, despite recognition that patients with LEP are not receiving equal care. Although previous research has identified time constraints and lack of availability of interpreters as reasons for their underuse, our data suggest that the reasons are far more complex. Residents at the study institutions with interpreters readily available found it easier to "get by" without an interpreter, despite misgivings about negative implications for quality of care. Findings suggest that increasing interpreter use will require interventions targeted at both individual physicians and the practice environment.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Int J Environ Res Public Health
                Journal ID (publisher-id): 101238455
                Title: International Journal of Environmental Research and Public Health
                Publisher: Molecular Diversity Preservation International (MDPI)
                ISSN (Print): 1661-7827
                ISSN (Electronic): 1660-4601
                Publication date (Print): July 2010
                Publication date (Electronic): 12 July 2010
                Volume: 7
                Issue: 7
                Pages: 2838-2844
                Affiliations
                [1 ] Department of Community Medicine and Primary Care, Geneva University Hospitals, Geneva, Switzerland; E-Mail: patricia.hudelson@ 123456hcuge.ch
                [2 ] Institute of Nursing Science, University of Basel, Basel, Switzerland
                Author notes
                [* ]Author to whom correspondence should be addressed; E-Mail: alexandre.bischoff@ 123456hcuge.ch ; Tel.: +41-22-372-96-72; Fax: +41-22-372-96-26.
                Article
                Publisher ID: ijerph-07-02838
                DOI: 10.3390/ijerph7072838
                PMC ID: 2922730
                PubMed ID: 20717543
                SO-VID: 5c39161b-9ca0-4608-92bc-846dd1e5c4a3
                Copyright © © 2010 by the authors; licensee Molecular Diversity Preservation International, Basel, Switzerland.
                License:

                This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

                History
                Date received : 7 June 2010
                Date revision received : 5 July 2010
                Date accepted : 6 July 2010
                Categories
                Subject: Article

                ScienceOpen disciplines: Public health
                Keywords: language barriers,migration,diversity,interpreting
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: language barriers, migration, diversity, interpreting

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