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Cross-Sectional Association of Patient Language and Patient-Provider Language Concordance with Video Telemedicine Use Among Patients with Limited English Proficiency

BACKGROUND: Telemedicine’s dramatic increase during the COVID-19 pandemic elevates the importance of addressing patient-care gaps in telemedicine, especially for patients with limited English proficiency. OBJECTIVE: To examine the associations of patient language and patient-provider language concor...

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Autores principales: Hsueh, Loretta, Huang, Jie, Millman, Andrea K., Gopalan, Anjali, Parikh, Rahul K., Teran, Silvia, Reed, Mary E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9649000/
https://www.ncbi.nlm.nih.gov/pubmed/36357732
http://dx.doi.org/10.1007/s11606-022-07887-6
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author Hsueh, Loretta
Huang, Jie
Millman, Andrea K.
Gopalan, Anjali
Parikh, Rahul K.
Teran, Silvia
Reed, Mary E.
author_facet Hsueh, Loretta
Huang, Jie
Millman, Andrea K.
Gopalan, Anjali
Parikh, Rahul K.
Teran, Silvia
Reed, Mary E.
author_sort Hsueh, Loretta
collection PubMed
description BACKGROUND: Telemedicine’s dramatic increase during the COVID-19 pandemic elevates the importance of addressing patient-care gaps in telemedicine, especially for patients with limited English proficiency. OBJECTIVE: To examine the associations of patient language and patient-provider language concordance with telemedicine visit type (video versus telephone visit). DESIGN: Cross-sectional automated data study of patient-scheduled primary care telemedicine appointments from March 16, 2020, to October 31, 2020. SETTING: Northern California integrated healthcare delivery system. PARTICIPANTS: All 22,427 completed primary care telemedicine visits scheduled by 13,764 patients with limited English proficiency via the patient portal. MEASUREMENTS: Cross-sectional association of electronic health record–documented patient language (Spanish as referent) and patient-provider language concordance with patients’ choice of a video (versus telephone) visit, accounting for patient sociodemographics, technology access, and technology familiarity factors. RESULTS: Of all patient-scheduled visits, 34.5% (n = 7747) were video visits. The top three patient languages were Spanish (42.4%), Cantonese (16.9%), and Mandarin (10.3%). Adjusting for sociodemographic and technology access and familiarity factors and compared to patients speaking Spanish, video visit use was higher among patients speaking Cantonese (OR = 1.34, 95% CI: 1.18–1.52), Mandarin (OR = 1.33, 95% CI: 1.16–1.52), or Vietnamese (OR = 1.27, 95% CI: 1.09–1.47), but lower among patients speaking Punjabi (OR = 0.75, 95% CI: 0.75, 0.62–0.91). Language concordance was associated with lower video visit use (OR = 0.86, 95% CI: 0.80–0.93) and moderated associations of speaking Spanish, Cantonese, and Korean with video visit use. In addition, for all language groups, those with prior video visit use were more likely to re-use video visits compared to those with no prior use (p < .05 for all languages except Hindi with p = 0.06). CONCLUSIONS: Among linguistically diverse patients with limited English proficiency, video telemedicine use differed by specific language. Disaggregating patient subpopulation data is necessary for identifying those at greatest risk of being negatively impacted by the digital divide. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11606-022-07887-6.
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spelling pubmed-96490002022-11-14 Cross-Sectional Association of Patient Language and Patient-Provider Language Concordance with Video Telemedicine Use Among Patients with Limited English Proficiency Hsueh, Loretta Huang, Jie Millman, Andrea K. Gopalan, Anjali Parikh, Rahul K. Teran, Silvia Reed, Mary E. J Gen Intern Med Original Research BACKGROUND: Telemedicine’s dramatic increase during the COVID-19 pandemic elevates the importance of addressing patient-care gaps in telemedicine, especially for patients with limited English proficiency. OBJECTIVE: To examine the associations of patient language and patient-provider language concordance with telemedicine visit type (video versus telephone visit). DESIGN: Cross-sectional automated data study of patient-scheduled primary care telemedicine appointments from March 16, 2020, to October 31, 2020. SETTING: Northern California integrated healthcare delivery system. PARTICIPANTS: All 22,427 completed primary care telemedicine visits scheduled by 13,764 patients with limited English proficiency via the patient portal. MEASUREMENTS: Cross-sectional association of electronic health record–documented patient language (Spanish as referent) and patient-provider language concordance with patients’ choice of a video (versus telephone) visit, accounting for patient sociodemographics, technology access, and technology familiarity factors. RESULTS: Of all patient-scheduled visits, 34.5% (n = 7747) were video visits. The top three patient languages were Spanish (42.4%), Cantonese (16.9%), and Mandarin (10.3%). Adjusting for sociodemographic and technology access and familiarity factors and compared to patients speaking Spanish, video visit use was higher among patients speaking Cantonese (OR = 1.34, 95% CI: 1.18–1.52), Mandarin (OR = 1.33, 95% CI: 1.16–1.52), or Vietnamese (OR = 1.27, 95% CI: 1.09–1.47), but lower among patients speaking Punjabi (OR = 0.75, 95% CI: 0.75, 0.62–0.91). Language concordance was associated with lower video visit use (OR = 0.86, 95% CI: 0.80–0.93) and moderated associations of speaking Spanish, Cantonese, and Korean with video visit use. In addition, for all language groups, those with prior video visit use were more likely to re-use video visits compared to those with no prior use (p < .05 for all languages except Hindi with p = 0.06). CONCLUSIONS: Among linguistically diverse patients with limited English proficiency, video telemedicine use differed by specific language. Disaggregating patient subpopulation data is necessary for identifying those at greatest risk of being negatively impacted by the digital divide. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11606-022-07887-6. Springer International Publishing 2022-11-10 2023-02 /pmc/articles/PMC9649000/ /pubmed/36357732 http://dx.doi.org/10.1007/s11606-022-07887-6 Text en © The Author(s), under exclusive licence to Society of General Internal Medicine 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
spellingShingle Original Research
Hsueh, Loretta
Huang, Jie
Millman, Andrea K.
Gopalan, Anjali
Parikh, Rahul K.
Teran, Silvia
Reed, Mary E.
Cross-Sectional Association of Patient Language and Patient-Provider Language Concordance with Video Telemedicine Use Among Patients with Limited English Proficiency
title Cross-Sectional Association of Patient Language and Patient-Provider Language Concordance with Video Telemedicine Use Among Patients with Limited English Proficiency
title_full Cross-Sectional Association of Patient Language and Patient-Provider Language Concordance with Video Telemedicine Use Among Patients with Limited English Proficiency
title_fullStr Cross-Sectional Association of Patient Language and Patient-Provider Language Concordance with Video Telemedicine Use Among Patients with Limited English Proficiency
title_full_unstemmed Cross-Sectional Association of Patient Language and Patient-Provider Language Concordance with Video Telemedicine Use Among Patients with Limited English Proficiency
title_short Cross-Sectional Association of Patient Language and Patient-Provider Language Concordance with Video Telemedicine Use Among Patients with Limited English Proficiency
title_sort cross-sectional association of patient language and patient-provider language concordance with video telemedicine use among patients with limited english proficiency
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9649000/
https://www.ncbi.nlm.nih.gov/pubmed/36357732
http://dx.doi.org/10.1007/s11606-022-07887-6
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