Abstract
Objective: This systematic review assessed whether physician–patient language concordance, compared with discordance, is associated with better health outcomes.Methods: A systematic literature search was conducted, without language restrictions, using PubMed, EMBASE, Web of Science, and PsycINFO, from inception to July 2020. We included studies that evaluated the effects of physician–patient language concordance on health outcomes. Articles were screened, selected, and data-extracted in duplicate. Review protocol was prospectively registered (PROSPERO, CRD42020157229).Results: There were 541 citations identified through databases and eight citations through reverse search and Google Scholar. A total of 15 articles (84,750 participants) were included reporting outcomes within five domains: diabetes care (four studies), inpatient care (five studies), cancer screening (three studies), healthcare counseling (two studies), and mental health care (one study). Ten studies were of good quality, four were fair, and one was poor, according to the modified Newcastle-Ottawa Scale. Eight studies (53%) showed a significant negative association between language discordance and at least one clinical outcome. Five studies (33%) found no association.Conclusion: Over half the evidence collated showed that physician–patient language concordance was associated with better health clinical outcomes.
Highlights
In the last decade, around 3.4% of the world population (258 million) has migrated, the majority into the United States (USA) (1)
Ten studies were of good quality, four studies were of fair quality (28, 29, 31, 32), and one study was of poor quality (30), with positive, negative, or no differences in health outcomes for the language discordance compared to the language concordance group (Supplementary Figure)
Two of our studies found that language concordance negatively impacted the rates of colorectal cancer screening, both of which focused on Spanish-speaking populations (19, 24)
Summary
Around 3.4% of the world population (258 million) has migrated, the majority into the United States (USA) (1). Language differences between healthcare providers and migrant patients, in addition to restrictive legal status and socioeconomic difficulties, are recognized as a major global healthcare barrier (4). The evidence of the negative effect of language discordance on healthcare provision is not completely understood. Language differences have been associated with medication non-compliance, adverse drug events, and underuse of preventative care (5, 6). Interpreters may play a role in addressing language discordance (7), but this intervention is associated with shortcomings including longer waiting times, increased consultation duration, and an increased financial burden on healthcare services (8). Insurance in private healthcare systems may not cover interpreter costs, and, surprisingly, only around half of EU member states provide free interpreting services (9). Alternative approaches in tackling language barriers are sought on a daily basis in health services, to varying effects
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
