Abstract
BackgroundPatient-Physician language discordance occurs when the patient and physician lack proficiency in the same language(s). Previous literature suggests language discordant clinical encounters compromise patient quality of care and health outcomes. The objective of this study was to quantify and visualize the linguistic and spatial mismatch between Ontario’s population not proficient in English or French but proficient in one of the top five non-official languages and the physicians who are proficient in the same non-official language.MethodsUsing data from the 2006 Canadian census and the 2006 Canadian Medical Directory, we determined the number of non-English/non-French (NENF) speaking individuals and the number of Ontario physicians proficient in the top five non-official languages in each census division (CD) of Ontario. For each non-official language, we produced bi-variate choropleth maps of Ontario, broken down into the 49 CDs, to determine which CDs had the highest risk of language discordant clinical encounters.ResultsAccording to the 2006 Canadian census, the top five non-official languages spoken by Ontario’s NENF population were: Chinese, Italian, Punjabi, Portuguese and Spanish. For each of the top five non-official languages, there were at least 5 census divisions with a NENF population speaking a non-official language without any primary care physicians proficient in that non-official language. The size of NENF populations within these CDs ranged from 10 individuals to 1,470 individuals.ConclusionsUnderstanding the linguistic capabilities of Ontario’s immigrant population & the linguistic capabilities of Ontario’s primary care physicians is essential to ensure equal access and quality of healthcare. As immigration continues to increase, we may find that the linguistic needs of Ontario’s immigrant population diverge from the linguistic capabilities of Ontario’s primary care physicians. Further research on the language discordance in Ontario is needed in order to reduce the risk of language discordant clinical encounters and the negative health outcomes associated with these encounters.
Highlights
Patient-Physician language discordance occurs when the patient and physician lack proficiency in the same language(s)
In addition to negative health outcomes, language barriers are associated with increased costs to the health care system; it is associated with increased diagnostic testing and increases in length of hospital stay [11]
After comparing the spatial distribution of Ontario’s NENF population and Ontario’s primary care physicians speaking the top five nonofficial languages, we found that, for all of the top five non-official languages, there were at least five census divisions that had a NENF population speaking that language without any physician capable of speaking any of the same non-official languages
Summary
Patient-Physician language discordance occurs when the patient and physician lack proficiency in the same language(s). Previous literature suggests language discordant clinical encounters compromise patient quality of care and health outcomes. It is especially important that primary care physicians are able to effectively communicate with patients as primary care physician’s are often the first point of access in the health care system. Despite these findings, there is still considerable evidence that physicians’ communication skills can be sub-. There is a growing body of literature that suggests language discordant clinical encounters can seriously compromise patient quality of care and health outcomes [4,5,6,7,8,9]. In addition to negative health outcomes, language barriers are associated with increased costs to the health care system; it is associated with increased diagnostic testing and increases in length of hospital stay [11]
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