Self-Reported Barriers to Healthcare and Interpreter Preferences for Patients with Limited-English-Proficiency in an Urban Emergency Department

Abstract

Introduction: In the United States, limited English proficient (LEP) patients often use emergency departments (ED) as their primary source of healthcare. Beyond language barriers, little is known about what other barriers LEP patients face to utilizing emergency care. The authors attempted to identify other barriers as well as gather data regarding patient preference for interpretation modality. Methods: A survey was administered to LEP patients at an urban, academic ED from June 2016 to September 2018. Participants rated 17 predetermined barriers and reported preferred interpretation modality. Results: The study population included 87 LEP participants from 13 countries, speaking 8 primary languages. The most common barriers “of high concern” were “paying the bill” (n=19), “wait time” (n=18), and “belief that professional care probably would not help” (n=15). A majority of participants (n=60, 61%) preferred in-person professional interpreters to other forms of interpretation. Conclusions: Addressing these specific barriers may improve access and utilization of emergency care for LEP patients. In-person professional interpreters should be utilized whenever possible.