Journal of General Internal Medicine

http://link.springer.com/journal/11606

List of Papers (Total 1,586)

Barriers Beyond Words: Cancer, Culture, and Translation in a Community of Russian Speakers

BACKGROUND Language and culture relate in complex ways. Addressing this complexity in the context of language translation is a challenge when caring for patients with limited English proficiency (LEP). OBJECTIVE To examine processes of care related to language, culture and translation in an LEP population is the objective of this study. DESIGN We used community based participatory ...

The Impact of an Enhanced Interpreter Service Intervention on Hospital Costs and Patient Satisfaction

BACKGROUND Many health care providers do not provide adequate language access services for their patients who are limited English-speaking because they view the costs of these services as prohibitive. However, little is known about the costs they might bear because of unaddressed language barriers or the costs of providing language access services. OBJECTIVE To investigate how ...

The Impact of Medical Interpretation Method on Time and Errors

Background Twenty-two million Americans have limited English proficiency. Interpreting for limited English proficient patients is intended to enhance communication and delivery of quality medical care. Objective Little is known about the impact of various interpreting methods on interpreting speed and errors. This investigation addresses this important gap. Design Four scripted ...

The Legal Framework for Language Access in Healthcare Settings: Title VI and Beyond

Over the past few decades, the number and diversity of limited English speakers in the USA has burgeoned. With this increased diversity has come increased pressure—including new legal requirements—on healthcare systems and clinicians to ensure equal treatment of limited English speakers. Healthcare providers are often unclear about their legal obligations to provide language ...

The Impact of Language Barriers on Documentation of Informed Consent at a Hospital with On-Site Interpreter Services

BACKGROUND Informed consent is legally and ethically required before invasive non-emergent procedures. Language barriers make obtaining informed consent more complex. OBJECTIVE Determine the impact of language barriers on documentation of informed consent among patients in a teaching hospital with on-site interpreter services. DESIGN Matched retrospective chart review study. ...

Primary Language and Receipt of Recommended Health Care Among Hispanics in the United States

Background Disparities in health care services between Hispanics and whites in the United States are well documented. Objective The objective of the study was to determine whether language spoken at home identifies Hispanics at risk for not receiving recommended health care services. Design The design of the study was cross-sectional, nationally representative survey of households. ...

Measuring and Improving the Quality of Hospital Language Services: Insights from the Speaking Together Collaborative

In 2006, the Robert Wood Johnson Foundation launched Speaking Together: National Language Services Network, an initiative designed to improve the quality and availability of language services in US hospitals. Speaking Together works with hospitals that were selected through a competitive application process with multiple levels of review. The selection process targeted hospitals ...

Access to Mental Health Treatment by English Language Proficiency and Race/Ethnicity

Background Limited English proficiency (LEP) may contribute to mental health care disparities, yet empirical data are limited. Objective To quantify the language barriers to mental health care by race/ethnicity using a direct measure of LEP is the objective of the study. Design Cross-sectional analysis of the 2001 California Health Interview Survey is the study’s design. ...

Reducing Language Barriers and Racial/Ethnic Disparities in Health Care: An Investment in Our Future

In 2003, the Institute of Medicine issued a groundbreaking report that shone a spotlight on the problem of racial and ethnic disparities in health care in the United States.1 It is now well recognized that minority Americans tend to receive less care, and lower-quality care, than the majority (white) population. The reasons behind this phenomenon are complex and opaque. There is no ...

Implicit Bias among Physicians and its Prediction of Thrombolysis Decisions for Black and White Patients

Context Studies documenting racial/ethnic disparities in health care frequently implicate physicians’ unconscious biases. No study to date has measured physicians’ unconscious racial bias to test whether this predicts physicians’ clinical decisions. Objective To test whether physicians show implicit race bias and whether the magnitude of such bias predicts thrombolysis ...

Reliability, Validity and Responsiveness of the Syncope Functional Status Questionnaire

BACKGROUND Patients with transient loss of consciousness (TLOC) have poor health-related quality of life (HR-QoL). OBJECTIVE To test the reliability, validity, and responsiveness of the disease-specific Syncope Functional Status HR-QoL Questionnaire (SFSQ), which yields two summary scales—impairment score (IS) and fear–worry score (FWS). DESIGN Cohort-study. PARTICIPANTS 503 adult ...

Creating a More Resilient Safety Net for Persons with Chronic Disease: Beyond the “Medical Home”

Mega-disasters the scale and scope of Hurricane Katrina have been exceedingly rare in the USA. Nonetheless, careful study of such disasters can provide lessons learned that can lend essential insights to guide planning for future events of any size.1 Such disasters can also expose previously under-recognized frailties in society that, like the under-built levees of New Orleans, ...

Bioidentical Hormones for Menopausal Hormone Therapy: Variation on a Theme

BACKGROUND Progesterone creams and natural or bioidentical compounded estrogen preparations are being promoted to consumers as safe alternatives to conventional menopausal hormone therapy and as health-promoting tonics. No reliable data support these claims. SAFETY Natural hormones, including estradiol, estriol, estrone, and progesterone, can be expected to have the same adverse ...

Consumer Directed Healthcare: Except for the Healthy and Wealthy It’s Unwise

Many politicians and business leaders are advocating high deductible health insurance plans linked with health savings accounts—so-called consumer-directed healthcare. These policies penalize the sick, discourage needed care (especially primary and preventive care), and direct tax subsidies towards the wealthiest Americans. They offer little hope of slowing the growth of health ...