Relationship Between Patient-Provider Language Discordance and the Need for Professional Medical Interpretation for International Patients in Japan

Background: Language barriers between patients and healthcare providers pose significant challenges in medical care in Japanese hospitals. Inadequate patient understanding of discussions with healthcare providers because of patient-provider language discordance has been reported in previous studies. There are growing expectations of professional medical interpreters to address these challenges. A previous study reported that patients with patient-provider language discordance were more likely to need interpreter assistance compared with patients with patient-provider language concordance. Objective: We conducted a cross-sectional study utilizing a questionnaire survey of foreign patients to analyze the impact of the degree of patient-provider language discordance on the degree of patient comprehension of patient-provider communication, as well as patients’ need for professional medical interpreters in Japanese hospitals. Method: From February 2022 to May 2023, an online questionnaire was distributed to 4,962 individuals aged 18 years or older who were non-native speakers of Japanese and who had attended medical institutions in Japan because of illness or injury experienced by themselves or by their children. A chi-square test and residual analysis were used to analyze the relationship between patient-provider language discordance and patient comprehension of patient-provider language concordance. Logistic regression analysis was performed to analyze the relationship between patient-provider language discordance and the necessity of professional medical interpretation. Results: Among 4,962 study subjects who received the online survey, the total number of responses was 363 (7.3%). The rate of low-level patient comprehension was significantly higher in the patient-provider language discordance group compared with other groups. In a logistic regression model that accounted for sociodemographic factors, both the partial and complete patient-provider language discordance groups were more likely to want to use professional medical interpreters compared with the patient-provider language concordance group (OR: 4.16; 95% CI, 1.55-11.16; P=0.005; OR: 4.73; 95% CI, 1.70-13.18; P=0.003, respectively). Conclusion: The current findings suggest that hospitals should be better prepared to meet the potential language needs of international patients with no or limited use of Japanese in daily conversation.