In a new statewide study, researchers found that only 3 percent of New Jersey hospitals surveyed have full-time interpreters on duty, and just 20 percent train their staff members to work with interpreters.
The study authors estimate that there is one full-time, hospital-based interpreter for every 240,748 New Jersey residents with limited English-speaking skills.
The problem probably is not limited to New Jersey, said study lead author Dr. Glenn Flores, director of the Division of General Pediatrics at the University of Texas Southwestern Medical Center in Dallas. He estimates that many patients nationwide go without assistance from interpreters.
“We’re not doing the job we need to do,” Flores said, “and we’re violating a federal statute that says we should be doing this.”
Flores and colleagues sent a 37-question survey to hospitals in New Jersey in 2003 and 2004. The survey asked about interpreter services. Results from the 67 hospitals that responded appear in the May issue of the Journal of Health Care for the Poor and Underserved.
According to census estimates, about 12 percent of New Jersey residents have limited English-speaking skills. Still, nearly a third of the hospitals surveyed did not have multilingual signs, and one in five failed to offer written translations of medical information.
However, 97 percent of the hospitals surveyed had contracts with companies that provide interpreters by telephone.
When hospitals use telephone interpreters, it can be difficult for them to accompany patients to places like the X-ray room, Flores said. In some cases, he added, phone interpreters are not familiar with the regional variations of Spanish spoken by patients.
Federal law prohibits hospitals from discriminating by not providing adequate translation services, Flores said.
The study authors suggest several possible solutions, including greater enforcement of the law regarding interpreters and third-party reimbursement for them through federal aid programs like Medicaid.
Dr. Anne Beal, assistant vice president of the Commonwealth Fund, said the study is comprehensive and points to major problems in health care.
“If we want to get to high performance, we need to engage with and talk to our patients,” said Beal, whose organization has studied language barriers in medicine. Indeed, she said, “Patients who don’t speak English as their first language are much more likely to experience medical errors and have poor satisfaction with their health care.”