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Identification of Limited English Proficient Patients in Clinical Care
BACKGROUND: Standardized means to identify patients likely to benefit from language assistance are needed. OBJECTIVE: To evaluate the accuracy of the U.S. Census English proficiency question (Census-LEP) in predicting patients’ ability to communicate effectively in English. DESIGN: We investigated t...
Autores principales: | , , , , |
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Formato: | Texto |
Lenguaje: | English |
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Springer-Verlag
2008
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2533382/ https://www.ncbi.nlm.nih.gov/pubmed/18618200 http://dx.doi.org/10.1007/s11606-008-0693-y |
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author | Karliner, Leah S. Napoles-Springer, Anna M. Schillinger, Dean Bibbins-Domingo, Kirsten Pérez-Stable, Eliseo J. |
author_facet | Karliner, Leah S. Napoles-Springer, Anna M. Schillinger, Dean Bibbins-Domingo, Kirsten Pérez-Stable, Eliseo J. |
author_sort | Karliner, Leah S. |
collection | PubMed |
description | BACKGROUND: Standardized means to identify patients likely to benefit from language assistance are needed. OBJECTIVE: To evaluate the accuracy of the U.S. Census English proficiency question (Census-LEP) in predicting patients’ ability to communicate effectively in English. DESIGN: We investigated the sensitivity and specificity of the Census-LEP alone or in combination with a question on preferred language for medical care for predicting patient-reported ability to discuss symptoms and understand physician recommendations in English. PARTICIPANTS: Three hundred and two patients > 18 who spoke Spanish and/or English recruited from a cardiology clinic and an inpatient general medical-surgical ward in 2004–2005. RESULTS: One hundred ninety-eight (66%) participants reported speaking English less than “very well” and 166 (55%) less than “well”; 157 (52%) preferred receiving their medical care in Spanish. Overall, 135 (45%) were able to discuss symptoms and 143 (48%) to understand physician recommendations in English. The Census-LEP with a high-threshold (less than “very well”) had the highest sensitivity for predicting effective communication (100% Discuss; 98.7% Understand), but the lowest specificity (72.6% Discuss; 67.1% Understand). The composite measure of Census-LEP and preferred language for medical care provided a significant increase in specificity (91.9% Discuss; 83.9% Understand), with only a marginal decrease in sensitivity (99.4% Discuss; 96.7% Understand). CONCLUSIONS: Using the Census-LEP item with a high-threshold of less than “very well” as a screening question, followed by a language preference for medical care question, is recommended for inclusive and accurate identification of patients likely to benefit from language assistance. (246 words) |
format | Text |
id | pubmed-2533382 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2008 |
publisher | Springer-Verlag |
record_format | MEDLINE/PubMed |
spelling | pubmed-25333822008-10-01 Identification of Limited English Proficient Patients in Clinical Care Karliner, Leah S. Napoles-Springer, Anna M. Schillinger, Dean Bibbins-Domingo, Kirsten Pérez-Stable, Eliseo J. J Gen Intern Med Original Article BACKGROUND: Standardized means to identify patients likely to benefit from language assistance are needed. OBJECTIVE: To evaluate the accuracy of the U.S. Census English proficiency question (Census-LEP) in predicting patients’ ability to communicate effectively in English. DESIGN: We investigated the sensitivity and specificity of the Census-LEP alone or in combination with a question on preferred language for medical care for predicting patient-reported ability to discuss symptoms and understand physician recommendations in English. PARTICIPANTS: Three hundred and two patients > 18 who spoke Spanish and/or English recruited from a cardiology clinic and an inpatient general medical-surgical ward in 2004–2005. RESULTS: One hundred ninety-eight (66%) participants reported speaking English less than “very well” and 166 (55%) less than “well”; 157 (52%) preferred receiving their medical care in Spanish. Overall, 135 (45%) were able to discuss symptoms and 143 (48%) to understand physician recommendations in English. The Census-LEP with a high-threshold (less than “very well”) had the highest sensitivity for predicting effective communication (100% Discuss; 98.7% Understand), but the lowest specificity (72.6% Discuss; 67.1% Understand). The composite measure of Census-LEP and preferred language for medical care provided a significant increase in specificity (91.9% Discuss; 83.9% Understand), with only a marginal decrease in sensitivity (99.4% Discuss; 96.7% Understand). CONCLUSIONS: Using the Census-LEP item with a high-threshold of less than “very well” as a screening question, followed by a language preference for medical care question, is recommended for inclusive and accurate identification of patients likely to benefit from language assistance. (246 words) Springer-Verlag 2008-07-10 2008-10 /pmc/articles/PMC2533382/ /pubmed/18618200 http://dx.doi.org/10.1007/s11606-008-0693-y Text en © Society of General Internal Medicine 2008 |
spellingShingle | Original Article Karliner, Leah S. Napoles-Springer, Anna M. Schillinger, Dean Bibbins-Domingo, Kirsten Pérez-Stable, Eliseo J. Identification of Limited English Proficient Patients in Clinical Care |
title | Identification of Limited English Proficient Patients in Clinical Care |
title_full | Identification of Limited English Proficient Patients in Clinical Care |
title_fullStr | Identification of Limited English Proficient Patients in Clinical Care |
title_full_unstemmed | Identification of Limited English Proficient Patients in Clinical Care |
title_short | Identification of Limited English Proficient Patients in Clinical Care |
title_sort | identification of limited english proficient patients in clinical care |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2533382/ https://www.ncbi.nlm.nih.gov/pubmed/18618200 http://dx.doi.org/10.1007/s11606-008-0693-y |
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