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Titolo:
Comparing the use of physician time and health care resources among patients speaking English, Spanish, and Russian
Autore:
Kravitz, RL; Helms, LJ; Azari, R; Antonius, D; Melnikow, J;
Indirizzi:
Univ Calif Davis, Div Gen Med, Sacramento, CA 95817 USA Univ Calif Davis Sacramento CA USA 95817 en Med, Sacramento, CA 95817 USA Ctr Hlth Serv Res Primary Care, Sacramento, CA 95817 USA Ctr Hlth Serv ResPrimary Care Sacramento CA USA 95817 ento, CA 95817 USA Univ Calif Davis, Dept Econ, Sacramento, CA 95817 USA Univ Calif Davis Sacramento CA USA 95817 t Econ, Sacramento, CA 95817 USA Univ Calif Davis, Dept Stat, Sacramento, CA 95817 USA Univ Calif Davis Sacramento CA USA 95817 t Stat, Sacramento, CA 95817 USA Univ Calif Davis, Div Gen Med, Sacramento, CA 95817 USA Univ Calif Davis Sacramento CA USA 95817 en Med, Sacramento, CA 95817 USA Univ Calif Davis, Dept Family & Community Med, Sacramento, CA 95817 USA Univ Calif Davis Sacramento CA USA 95817 ty Med, Sacramento, CA 95817 USA
Titolo Testata:
MEDICAL CARE
fascicolo: 7, volume: 38, anno: 2000,
pagine: 728 - 738
SICI:
0025-7079(200007)38:7<728:CTUOPT>2.0.ZU;2-N
Fonte:
ISI
Lingua:
ENG
Soggetto:
LANGUAGE BARRIERS; EMERGENCY; MEDICINE;
Keywords:
limited English proficiency; Spanish; Russian; costs of health care; resource utilization; medical interpreters;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Clinical Medicine
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Kravitz, RL Univ Calif Davis, Div Gen Med, PSSB 2500,4150 V St, Sacramento, CA 95817 USA Univ Calif Davis PSSB 2500,4150 V St Sacramento CA USA 95817A
Citazione:
R.L. Kravitz et al., "Comparing the use of physician time and health care resources among patients speaking English, Spanish, and Russian", MED CARE, 38(7), 2000, pp. 728-738

Abstract

BACKGROUND AND OBJECTIVES. The number of US residents with limited Englishproficiency (LEP) is 14 million and rising. The goal of this study was to estimate the effects of LEP on physician time and resource use. DESIGN. This was a prospective, observational study. SETTING AND SUBJECTS. The study included 285 Medicaid patients speaking English (n = 112) Spanish (n = 62), or Russian (n = 111) visiting the GeneralMedicine and Family Practice Clinics at the UC Davis Medical Center in 1996-1997 (participation rate, 85%). Bilingual research assistants administered patient questionnaires, abstracted the medical record, and conducted detailed time and motion studies. MAIN OUTCOME MEASURES. We used seemingly unrelated regression models to evaluate the effect of language on visit time, controlling for patient demographics and health status, physician specialty, visit type, and resident involvement in care. We also estimated the effect of LEP on cross-sectional utilization of health care resources and adherence to follow-up with referraland testing appointments. RESULTS. The 3 language groups differed significantly by age, education, and reason for visit but not gender, number of active medical conditions, physical functioning, or mental health Physician visit time averaged 38+/-20 minutes (mean+/-SD). Compared with English-speaking patients and after multivariate adjustment, Spanish and Russian speakers averaged 9.1 and 5.6 additional minutes of physician time, respectively (P < 0.05). The language effect was confined largely to follow-up visits with resident physicians (house staff). Compared with English speakers, Russian speakers had more referrals (P = 0.003) and Spanish speakers were less Likely to follow-up with recommended laboratory studies (P = 0.031). CONCLUSIONS. In these academic primary care clinics, some groups of patients using interpreters required more physician time than those proficient inEnglish Additional reimbursement may be needed to ensure continued access and high-quality care for this special population.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/09/20 alle ore 23:52:09