'What We Have Here is a Failure to Communicate': Association of Preferred Language With the Rate of Psychiatric Consultation

Autor: Peter A. Shapiro, Adrienne D. Mishkin, Stephanie G. Cheung
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
Urban Population
020205 medical informatics
Population
02 engineering and technology
computer.software_genre
Medical care
03 medical and health sciences
0302 clinical medicine
Arts and Humanities (miscellaneous)
0202 electrical engineering
electronic engineering
information engineering
medicine
Humans
030212 general & internal medicine
Cultural Competency
Psychiatry
Association (psychology)
education
Referral and Consultation
Applied Psychology
Language
Academic Medical Centers
Physician-Patient Relations
education.field_of_study
Adult patients
business.industry
Communication
Mental Disorders
Medical record
Middle Aged
Psychiatry and Mental health
Psychiatric consultation
Limited English proficiency
Family medicine
Female
New York City
business
computer
Interpreter
Zdroj: Psychosomatics. 58:421-426
ISSN: 0033-3182
DOI: 10.1016/j.psym.2017.02.006
Popis: Background In the United States, people with limited English proficiency (LEP) receive poorer medical care than those proficient in English. Few studies demonstrate how linguistic barriers complicate psychiatric care; in consultation-liaison (C-L) psychiatry, there are no published data about care disparities for patients with LEP or for whom English is not the preferred language (PL). Objective We sought to determine if PL affects the psychiatric consultation rate. Methods Among adult patients admitted during 1 year to a large urban academic medical center, we compared psychiatric consultation rates in English PL patients with non-English PL patients. PL was ascertained from demographics during the medical record. The occurrence of psychiatric consultation was ascertained from C-L service logs. Results There were 54,534 admissions: the no-consultation group ( N = 53,196) and the consultation group ( N = 1,398). English as PL was more common in the consult group (72.0% of consult group, 62.0% of no-consult group, χ 2 = 92.98, p χ 2 = 98.78, p Conclusion Primary teams requested more consultations for patients whose PL was English than for patients with other PLs, suggesting that psychiatric needs of patients with non-English PL may be unaddressed. This is the first study to demonstrate a disproportionately low rate of general hospital psychiatric consultations in this population. Further study is necessary to confirm and understand this disparity. We recommend routine use of professional interpreters and low threshold for consultation in patients with non-English PL.
Databáze: OpenAIRE
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