Table 2.
The Impact of Professional and Ad Hoc Interpreters Combined (N = 7)
| Author (Year) Country | N | Comparison Groups | Interpreter Type Professionals Trained? (Yes/ No/Unclear) | Control for Confounders (Yes/No) or Qualitative Methods | Outcome Related to Interpreters | Results Related to Interpreters (Statistical Analysis/Test) |
|---|---|---|---|---|---|---|
| Comprehension & Errors | ||||||
| Baker et al. (1996), United States | 530 | LEP interpreted versus LEP noninterpreted versus language concordant* | In-person professional (Trained: unclear); ad hoc—family & friends, staff | No | Understanding of ED diagnosis nderstanding of ED treatment Measured knowledge of diagnosis & treatment | LEP patients with interpreters had higher understanding of diagnoses (57%) and treatment plan (82%) than LEP without interpreters (38% and 58%); language concordant group had highest perceived understanding (67% and 86%). p < 0.001 for all comparisons. No significant differences in measured knowledge of diagnosis and treatment (low in all groups). (χ2) |
| Drennan and Swartz (2002), South Africa | Not stated/unclear | LEP interpreted versus LEP noninterpreted | In person professional (Trained: yes); ad hoc—family & staff | Qualitative—semi-structured interviews, direct | observations, chart reviews | Misattribution of psychiatric symptoms and diagnoses Misattribution less common with interpreter use. (ethnographic and discourse analyses) |
| Utilization | ||||||
| Sarver and Baker (2000), United States | 714 | LEP interpreted versus LEP noninterpreted versus language concordant | In-person professional (Trained: unclear): ad hoc—family & friends, staff | Yes | Referral & adherence to follow-up from ED | All LEP had lower, but not statistically significant, referral rates for follow-up than language concordant, (76% versus 75% versus 83%; p = 0.05); all patients had similar adherence to follow-up. (χ2; multiple logistic regression) |
| Clinical Outcomes | ||||||
| Dodd (1984), Saudi Arabia | 16,945 | Arabic speaking versus non-Arabic speaking doctors using interpreters; (all patients Arabic speakers) | In-person professional (Trained: unclear); ad hoc—clinic nurses | No | Rates of diagnoses: Mental illness; “signs, symptoms and ill-defined conditions” | Equal rates of diagnoses for Arabic and non-Arabic speaking doctors using interpreters. (12 per 1,000 versus 14 per 1,000; p > 0.1; χ2) |
| Small et al. (1999), Australia | 318 | LEP interpreted versus LEP noninterpreted versus language concordant | In-person professional (Trained: unclear); ad hoc—family & staff | No | Cesarean section rate | LEP without interpreters had highest Cesarean section rates (39%); those with interpreters had rates closer to English speakers (19% versus 24%). LEP without interpreters were twice as likely to have a c-section as those with interpreters. (OR 2.7; 95% CI 1.0–8.4) (Mantel-Haenszel odds ratio) |
| Satisfaction | ||||||
| Baker, Hayes, and Fortier (1998), United States | 457 | LEP Interpreted versus LEP noninterpreted versus Language concordant | In-person professional (Trained: unclear); ad hoc—family & friends, staff | Yes | Satisfaction with interpersonal aspects of care in the ED | Patients without interpreters had the lowest mean satisfaction score compared with language concordant patients (p < 0.001); those using interpreters had somewhat higher scores, but still lower than language concordant patients (p = 0.005). (multiple linear regression) |
| Derose et al. (2001), United States | 599 | LEP interpreted versus LEP noninterpreted versus language concordant | In-person professional (Trained: unclear); ad hoc—family & friends, staff | Yes | Gender differences in satisfaction with interpersonal aspects of care in the ED | Women without interpreters were less satisfied on all seven measures than those either with interpreters or with language concordance, (p < 0.01). Interpreters only slightly increased satisfaction for men. (ordered logit regression) |
*
Language concordant refers to encounters in which both the patient and the clinician speak the same language; this is most often English, but may be in another language in a non-English-speaking country (e.g., Arabic in Saudi Arabia), or in a non-majority language (e.g., Spanish or Chinese in the United States).