50. J Gen Intern Med. 2007 Nov;22 Suppl 2:306-11.
The impact of an enhanced interpreter service intervention on hospital costs and
patient satisfaction.
Jacobs EA, Sadowski LS, Rathouz PJ.
Collaborative Research Unit, John H. Stroger Jr. Hospital of
BACKGROUND: Many health care providers do not provide adequate language access
services for their patients who are limited English-speaking because they view
the costs of these services as prohibitive. However, little is known about the
costs they might bear because of unaddressed language barriers or the costs of
providing language access services.
OBJECTIVE: To investigate how language barriers and the provision of enhanced
interpreter services impact the costs of a hospital stay.
DESIGN: Prospective intervention study.
SETTING: Public hospital inpatient medicine service.
PARTICIPANTS: Three hundred twenty-three adult inpatients: 124 Spanish-speakers
whose physicians had access to the enhanced interpreter intervention, 99
Spanish-speakers whose physicians only had access to usual interpreter services,
and 100 English-speakers matched to Spanish-speaking participants on age, gender,
and admission firm.
MEASUREMENTS: Patient satisfaction, hospital length of stay, number of inpatient
consultations and radiology tests conducted in the hospital, adherence with
follow-up appointments, use of emergency department (ED) services and
hospitalizations in the 3 months after discharge, and the costs associated with
provision of the intervention and any resulting change in health care
utilization.
RESULTS: The enhanced interpreter service intervention did not significantly
impact any of the measured outcomes or their associated costs. The cost of the
enhanced interpreter service was $234 per Spanish-speaking intervention patient
and represented 1.5% of the average hospital cost. Having a Spanish-speaking
attending physician significantly increased Spanish-speaking patient satisfaction
with physician, overall hospital experience, and reduced ED visits, thereby
reducing costs by $92 per Spanish-speaking patient over the study period.
CONCLUSION: The enhanced interpreter service intervention did not significantly
increase or decrease hospital costs. Physician-patient language concordance
reduced return ED visit and costs. Health care providers need to examine all the
cost implications of different language access services before they deem them too
costly.
PMCID: PMC2078550
PMID: 17957416 [PubMed - indexed for MEDLINE]