• Yael Schenker, Andrew J Karter, Dean Schillinger, E Margaret Warton, Nancy E Adler, Howard H Moffet, Ameena T Ahmed, and Alicia Fernandez.
• Department of Medicine, University of California, San Francisco, CA 94143, USA. yael.schenker@ucsf.edu
• Patient Educ Couns. 2010 Nov 1; 81 (2): 222-8.

ObjectiveTo assess the association of limited English proficiency (LEP) and physician language concordance with patient reports of clinical interactions.MethodsCross-sectional survey of 8638 Kaiser Permanente Northern California patients with diabetes. Patient responses were used to define English proficiency and physician language concordance. Quality of clinical interactions was based on 5 questions drawn from validated scales on communication, 2 on trust, and 3 on discrimination.ResultsRespondents included 8116 English-proficient and 522 LEP patients. Among LEP patients, 210 were language concordant and 153 were language discordant. In fully adjusted models, LEP patients were more likely than English-proficient patients to report suboptimal interactions on 3 out of 10 outcomes, including 1 communication and 2 discrimination items. In separate analyses, LEP-discordant patients were more likely than English-proficient patients to report suboptimal clinician-patient interactions on 7 out of 10 outcomes, including 2 communication, 2 trust, and 3 discrimination items. In contrast, LEP-concordant patients reported similar interactions to English-proficient patients.ConclusionsReports of suboptimal interactions among patients with LEP were more common among those with language-discordant physicians.Practice ImplicationsExpanding access to language concordant physicians may improve clinical interactions among patients with LEP. Quality and performance assessments should consider physician-patient language concordance.Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

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