Table 2. The important findings from the 14 studies identified.

Author	Focus	Results
Albrecht et al,8	Online translation tools	In case of reducing the cost of care (interpreter services), Google Translate and MediBabble application used in health organizations. Participants stated: - Free and easy to access (92%). - Saves time at the visit (92%). - Improves health care delivery and patient safety (92%).
Ali et al,9	Impact on the provision of care	Limited English proficient patients (LEPPs) reported they had missing appointments and difficulties in arranging appointments because of language barriers.
Al-Khathami et al,10	Patients satisfaction with the health services delivered by non-Arabic speakers (nurses)	The overall satisfaction of patients about nurse’s care was 90%. Whereas, patients reported they had a concern about language barriers while delivering health care. Patients reported the following: - 30% of patients have difficulties in understanding the instructions of non-Arabic speaking nurses (NASNs). - 30% have a problem with the reliability of the information delivered by NASNs. - 50% believed that the language barrier is contributed to more susceptible to error. - 50% avoid and 70% end conversation. - 40% called for an interpreter.
Bagchi et al,11	Cost of interpretation services for Medicaid recipients	Non-English-speaking patients who used the interpreter services received more inpatient services and office visits. Providing interpreter services for Medicaid recipients was estimated at $ 4.7 million annually.
Bischoff et al,2	Cost of health care	- 26.4% of LEPPs reported no interpreter. - LEPPs increased the cost of health care indirectly by using an interpreter.
Bischoff et al,12	Asylum seekers and refugees	- 11% of nurses reported poor communication with asylum seekers. - 76% of nurses stated there was no interpreter support when they need.
de Moissac et al,13,14	Patient satisfaction	The language barrier caused: - 66.7% of LEPPs reported that they had a barrier to accessing healthcare. - 20% of LEPPs indicated that not seeking health care services if these were not available for fear of not understanding. - 70.7% of LEPPs reported that the limited availability of interpreter services. - Increased stress and decreased confidence that health care service received were appropriate.
Divi et al,5	Adverse events and patient satisfaction	LEPPs had adverse events, which resulted in: - Detectable physical harm (49.1% of LEPPs). - Moderate temporary harm or worse (46.8%). - Some failure in communication (52.4%).
Kale et al,15	Cultural communication in health and health provider satisfaction	- 30% of health providers reported that they used interpreters daily because of the large immigrant patient population. - Physicians and nurses reported that they need for interpreters with 43.2% and 36.5% cases (who understand of Norwegian is insufficient), respectively. - 21% of health providers stated that there was poor access to interpreter services. - 37% of physicians reported they felt that patients hide some information because of the language barrier.
Ngo-Metzger et al,16	Quality of interpersonal care	Patients with language-discordant providers reported receiving worse interpersonal care and less health education.
Pytel et al,17	Communication and patient satisfaction	About 89% of patients reported that nurses speak in a way that meets their language needs, and that is an important item for communication needs. Whereas, 94.3% of nurses reported that it is very important for work and communication environments to understand the language of patients.
Schlemmer et al,18	Language barrier on health workers and patients	Patients had poor satisfaction with care due to language barrier. Doctors did not understand patients who speak a different language, leading to wrong diagnosis and medication.
Van Rooyen et al,19	South African (SA) nurses’ satisfaction	SA nurses had communication barriers: - They had a big challenge of communication with patients and their family members because of the language barriers. - SA nurses were not interested in learning the Arabic language, but know a few words just for simple communication. - SA nurses had some difficulty in speaking with other nurses from other countries because their English speaking was in some way different.
Wilson et al,20	Adverse medication and patient satisfaction	LEPPs had problems with medical comprehension, which resulted in: - Problem understanding a medical situation (49%). - Confused about how to use medication (34.7%). - Trouble understanding the label on the medication (41.8%). - Bad reaction to medication due to problem understanding instructions (15.8%).