Cost Effectiveness of Language Services in Hospital Emergency Departments (EDs)

Numerous studies suggest that the use of in-person, professionally trained medical interpreters can reduce health care costs associated with diagnosing and treating patients with limited English proficiency. However, few studies have specifically addressed the question of the cost-effectiveness of language services in health care settings. This study used a randomized controlled study design to compare the cost-effectiveness of using professional interpreters with Spanish-speaking patients seen in hospital emergency departments (EDs) versus using the usual language services available to these patients. The main goal of the study was to estimate the effect that professional interpreters have on resource utilization and patient/provider satisfaction in the ED compared to the language services usually offered in these settings. Our hypothesis was that use of trained interpreters would lead to more cost-effective provision of ED services.

Limited English proficiency, Cost-effectiveness, Emergency Departments, Language Discordance, Satisfaction, Limited English proficient patients, Spanish-speaking patients

Limited English proficient Spanish-speaking patients seen in the treatment arm were provided with the services of a professionally-trained medical interpreter to facilitate communication between the patient and emergency department staff

Patients randomized to the control arm receive the services of the emergency departments' usual language services (i.e., a telephone language line or ad hoc interpreters).

All treatment interpreters were certified bilingual in Spanish and English and had completed (1) at least 40 hours of training in medical terminology, ethics, patient privacy, and basic interpreting skills; and (2) an online course in protection of human subjects.

Inclusion Criteria: limited English proficient (LEP) Spanish-speaking patients adults aged 18 or older LEP parents of children seen in emergency departments Exclusion Criteria: cognitively impaired, comatose, or traumatized patients healthy volunteers prisoners hospital employees