Skip to main content
Top
Published in: Journal of Immigrant and Minority Health 3/2008

01-06-2008 | Original Paper

Health Services Utilization by Low-Income Limited English Proficient Adults

Authors: Elinor A. Graham, Troy A. Jacobs, Tao Sheng Kwan-Gett, Jane Cover

Published in: Journal of Immigrant and Minority Health | Issue 3/2008

Login to get access

Abstract

Objectives We evaluated the health care utilization of limited English proficiency (LEP) compared to English proficient (EP) adults with the same health insurance (Medicaid managed care) and full access to professional medical interpreters. Methods Health care utilization over two years was compared for 567 LEP and 1162 EP adults. Multivariate analysis controlled for age, gender, months enrolled in Medicaid and morbidity. Results LEP compared to EP subjects were enrolled longer and more continuously in Medicaid, were 94% more likely to use primary care and 78% less likely to use the emergency department. Specialty visits and hospitalization did not differ. Conclusions When language barriers are reduced and health insurance coverage is the same, LEP patients show ambulatory health care utilization associated with lower cost and more access to preventive care through establishing a primary care home.
Literature
1.
go back to reference Profile of the Foreign-Born Population in the United States: 2000, Current Population Reports. December 2001:23–206. Profile of the Foreign-Born Population in the United States: 2000, Current Population Reports. December 2001:23–206.
2.
go back to reference US Census Bureau, Health Insurance Coverage: 2000, http://www.census.gov/hhes/hlthins/hlthin00/hi00tc.html. US Census Bureau, Health Insurance Coverage: 2000, http://​www.​census.​gov/​hhes/​hlthins/​hlthin00/​hi00tc.​html.​
3.
go back to reference Mohanty SA, Woolhandler S, Himmelstein DU, et al. Health care expenditures of immigrants in the United States: a nationally representative analysis. Am J Public Health 2005;95:1431–8.PubMed Mohanty SA, Woolhandler S, Himmelstein DU, et al. Health care expenditures of immigrants in the United States: a nationally representative analysis. Am J Public Health 2005;95:1431–8.PubMed
4.
go back to reference National Health Law Program and the Access Project: 2004. Language services action kit. Washington, DC: National Health Law Program. http://www.healthlaw.org/pubs/2004. National Health Law Program and the Access Project: 2004. Language services action kit. Washington, DC: National Health Law Program. http://​www.​healthlaw.​org/​pubs/​2004.​
5.
go back to reference Woloshin S, Bickell NA, Schwartz LM, et al. Language barriers in medicine in the United States. JAMA 1995;273:724–8.PubMedCrossRef Woloshin S, Bickell NA, Schwartz LM, et al. Language barriers in medicine in the United States. JAMA 1995;273:724–8.PubMedCrossRef
6.
go back to reference Wilson E, ChenA, Grumbach K, et al. Effects of limited English proficiency and physician language on health care comprehension. J Gen Intern Med 2005;20:800–6.PubMedCrossRef Wilson E, ChenA, Grumbach K, et al. Effects of limited English proficiency and physician language on health care comprehension. J Gen Intern Med 2005;20:800–6.PubMedCrossRef
7.
go back to reference Jacobs EA, Karavolos K, Rathouz PJ, et al. Limited English proficiency and breast and cervical cancer screening in a multiethnic population. Am J Public Health 2005;95:1410–6.PubMedCrossRef Jacobs EA, Karavolos K, Rathouz PJ, et al. Limited English proficiency and breast and cervical cancer screening in a multiethnic population. Am J Public Health 2005;95:1410–6.PubMedCrossRef
8.
go back to reference Perez-Stable EJ, Napoles-Springer AN, Miramontes JM. The effects of ethnicity and language on medical outcomes of patients with hypertension or diabetes. Med Care 1997;35:1212–9.PubMedCrossRef Perez-Stable EJ, Napoles-Springer AN, Miramontes JM. The effects of ethnicity and language on medical outcomes of patients with hypertension or diabetes. Med Care 1997;35:1212–9.PubMedCrossRef
9.
go back to reference Tocher TM, Larson E. Quality of diabetes care for non-English-speaking patients: A comparative study. West J Med 1998;168:504–11.PubMed Tocher TM, Larson E. Quality of diabetes care for non-English-speaking patients: A comparative study. West J Med 1998;168:504–11.PubMed
10.
go back to reference Stein JA, Fox SA. Language preference as an indicator of mammography use among Hispanic women. J Natl Cancer Inst 1990;82:1715–6.PubMedCrossRef Stein JA, Fox SA. Language preference as an indicator of mammography use among Hispanic women. J Natl Cancer Inst 1990;82:1715–6.PubMedCrossRef
11.
go back to reference Pachter LM, Weller SC. Acculturation and compliance with medical therapy. JDBP 1993;14:163–7.PubMed Pachter LM, Weller SC. Acculturation and compliance with medical therapy. JDBP 1993;14:163–7.PubMed
12.
go back to reference Manson A. Language concordance as a determinant of patient compliance and emergency room use in patients with asthma. Med Care 1998;26:1119–28.CrossRef Manson A. Language concordance as a determinant of patient compliance and emergency room use in patients with asthma. Med Care 1998;26:1119–28.CrossRef
13.
go back to reference Woloshin S, Schwartz LM, Katz SJ, et al. Is language a barrier to the use of preventive services? JGIM 1997;12:472–7.PubMedCrossRef Woloshin S, Schwartz LM, Katz SJ, et al. Is language a barrier to the use of preventive services? JGIM 1997;12:472–7.PubMedCrossRef
14.
go back to reference Jang M, Lee E, Woo K. Income, language, and citizenship status: factors affecting the health care access and utilization of Chinese Americans. Health Social Work 1998;23:136–45.PubMed Jang M, Lee E, Woo K. Income, language, and citizenship status: factors affecting the health care access and utilization of Chinese Americans. Health Social Work 1998;23:136–45.PubMed
15.
go back to reference Derose KP, Baker DW. Limited English proficiency and Latinos’ use of physician services. Med Care Res Rev 2000;57:76–91.PubMedCrossRef Derose KP, Baker DW. Limited English proficiency and Latinos’ use of physician services. Med Care Res Rev 2000;57:76–91.PubMedCrossRef
16.
go back to reference Andrulis D, Goodman N, Pryor C. What a difference an interpreter can make. Health care experiences of uninsured with limited English proficiency. The Access Project, Center for Community Health Research and Action, Brandeis University, Boston, MA; 2002. Andrulis D, Goodman N, Pryor C. What a difference an interpreter can make. Health care experiences of uninsured with limited English proficiency. The Access Project, Center for Community Health Research and Action, Brandeis University, Boston, MA; 2002.
17.
go back to reference Flores G. The impact of medical interpreter services on the quality of health care: a systematic review. Medical Care Res Rev 2005;62:255–299.CrossRef Flores G. The impact of medical interpreter services on the quality of health care: a systematic review. Medical Care Res Rev 2005;62:255–299.CrossRef
18.
go back to reference Kogan MD, Alexander GR, Jack BW, et al. The effects of gaps in health insurance on continuity of a regular source of care among preschool aged children in the United States. JAMA 1995;274:1429–1435.PubMedCrossRef Kogan MD, Alexander GR, Jack BW, et al. The effects of gaps in health insurance on continuity of a regular source of care among preschool aged children in the United States. JAMA 1995;274:1429–1435.PubMedCrossRef
19.
go back to reference Fleiss JL. Statistical methods for rates & proportions. New York, NY: Wiley; 1981. Fleiss JL. Statistical methods for rates & proportions. New York, NY: Wiley; 1981.
20.
go back to reference Sturmer T, Glynn RJ, Kliedsch U, et al. Analytic strategies for recurring events in epidemiological studies: Background and application to hospital risk in the elderly. J Clin Epidemiol 2000;53:57–64.PubMedCrossRef Sturmer T, Glynn RJ, Kliedsch U, et al. Analytic strategies for recurring events in epidemiological studies: Background and application to hospital risk in the elderly. J Clin Epidemiol 2000;53:57–64.PubMedCrossRef
21.
go back to reference Berman S, Bondy J, Lezotte D, et al. The influence of having an assigned Medicaid primary care physician on utilization of otitis media-related services. Pediatrics 1999;104:1192–7.PubMed Berman S, Bondy J, Lezotte D, et al. The influence of having an assigned Medicaid primary care physician on utilization of otitis media-related services. Pediatrics 1999;104:1192–7.PubMed
22.
go back to reference Jacobs EA, Lauderdale DS, Meltzer D, et al. Impact of interpreter services on delivery of care to limited—English-proficient patients. J Gen Intern Med 2001;16:468–74.PubMedCrossRef Jacobs EA, Lauderdale DS, Meltzer D, et al. Impact of interpreter services on delivery of care to limited—English-proficient patients. J Gen Intern Med 2001;16:468–74.PubMedCrossRef
23.
go back to reference Hampers LC, McNulty JE. Professional interpreters and bilingual physicians in a pediatric emergency department. Arch Pediatr Adolesc Med 2002;156:1108–13.PubMed Hampers LC, McNulty JE. Professional interpreters and bilingual physicians in a pediatric emergency department. Arch Pediatr Adolesc Med 2002;156:1108–13.PubMed
24.
go back to reference Baker DW, Parker RM, Williams MV, et al. Use and effectiveness of interpreters in an emergency department. JAMA 1996;275:783–8.PubMedCrossRef Baker DW, Parker RM, Williams MV, et al. Use and effectiveness of interpreters in an emergency department. JAMA 1996;275:783–8.PubMedCrossRef
25.
go back to reference Asseyr AF, Businco L. Atopic sensitization in children of Somali immigrants in Italy. J Investig Allergol Clin Immunol 1994;4:192–296.PubMed Asseyr AF, Businco L. Atopic sensitization in children of Somali immigrants in Italy. J Investig Allergol Clin Immunol 1994;4:192–296.PubMed
26.
go back to reference Sladden MJ, Dure-Smith B, Berth-Jones J, et al. Ethnic differences in the pattern of skin disease seen in a dermatology department—atopic dermatitis is more common among Asian referrals in Leicestershire. Clin Exp Dermatol 1991;16:348–9.PubMedCrossRef Sladden MJ, Dure-Smith B, Berth-Jones J, et al. Ethnic differences in the pattern of skin disease seen in a dermatology department—atopic dermatitis is more common among Asian referrals in Leicestershire. Clin Exp Dermatol 1991;16:348–9.PubMedCrossRef
27.
go back to reference Tedeschi A, Barcella M, Bo GA, et al. Onset of allergy and asthma symptoms in extra-European immigrants to Milan, Italy: possible role of environmental factors. Clin Exp Allergy 2003;33:449–54.PubMedCrossRef Tedeschi A, Barcella M, Bo GA, et al. Onset of allergy and asthma symptoms in extra-European immigrants to Milan, Italy: possible role of environmental factors. Clin Exp Allergy 2003;33:449–54.PubMedCrossRef
28.
go back to reference Dervaderics M, Fust G, Otos M, et al. Differences in the sensitization to ragweed pollen and occurrence of late summer allergic symptoms between native and immigrant workers of the nuclear power plant of Hungary. Immunol Invest 2002;31:29–40.PubMedCrossRef Dervaderics M, Fust G, Otos M, et al. Differences in the sensitization to ragweed pollen and occurrence of late summer allergic symptoms between native and immigrant workers of the nuclear power plant of Hungary. Immunol Invest 2002;31:29–40.PubMedCrossRef
29.
go back to reference Knox SA, Britt H. A comparison of general practice encounters with patients from English-speaking and non-English speaking backgrounds. Med J Aust 2002;177:98–101.PubMed Knox SA, Britt H. A comparison of general practice encounters with patients from English-speaking and non-English speaking backgrounds. Med J Aust 2002;177:98–101.PubMed
30.
go back to reference Haub C. “2006 World population data sheet" The Population Reference Bureau, 2006. Haub C. “2006 World population data sheet" The Population Reference Bureau, 2006.
Metadata
Title
Health Services Utilization by Low-Income Limited English Proficient Adults
Authors
Elinor A. Graham
Troy A. Jacobs
Tao Sheng Kwan-Gett
Jane Cover
Publication date
01-06-2008
Publisher
Springer US
Published in
Journal of Immigrant and Minority Health / Issue 3/2008
Print ISSN: 1557-1912
Electronic ISSN: 1557-1920
DOI
https://doi.org/10.1007/s10903-007-9069-3

Other articles of this Issue 3/2008

Journal of Immigrant and Minority Health 3/2008 Go to the issue