Alicia Fernández|Dean Schillinger|E. Margaret Warton|Nancy E. Adler|Howard H. Moffet|Yael Schenker|María Victoria Salgado|Ameena T. Ahmed|Andrew J. Karter
Language Barriers, Physician-Patient Language Concordance, and Glycemic Control Among Insured Latinos with Diabetes: The Diabetes Study of Northern California (DISTANCE)
University of California, San Francisco|San Francisco General Hospital|Kaiser Permanente|Kaiser Permanente|University of California, San Francisco|University of California, San Francisco|Kaiser Permanente|Kaiser Permanente
significant proportion us latinos diabetes limited english proficiency lep whether language barriers health care contribute poor glycemic control unknownto assess association limited english proficiency lep glycemic control whether association modified languageconcordant physiciancrosssectional observational study using data 20052006 diabetes study northern california distance patients received care managed care setting interpreter services selfreported english language ability spanish language ability physician outcome poor glycemic control glycosylated hemoglobin a1c 9the unadjusted percentage patients poor glycemic control similar among latino patients lep n 510 latino englishspeakers n 2683 higher groups whites n 3545 21 vs 18 vs 10 p 0005 relationship differed significantly patientprovider language concordance p 001 interaction lep patients languagediscordant physicians n 115 likely lep patients languageconcordant physicians n 137 poor glycemic control 278 vs 161 p 002 controlling potential demographic clinical confounders lep latinos languageconcordant physicians similar odds poor glycemic control latino english speakers 089 ci 053149 whereas lep latinos languagediscordant physicians greater odds poor control latino english speakers 176 ci 104297 among lep latinos language discordant physician associated significantly poorer glycemic control 198 ci 103380language barriers contribute health disparities among latinos diabetes limited english proficiency independent predictor poor glycemic control among insured us latinos diabetes association observed care provided languageconcordant physicians future research determine strategies increase languageconcordant care improve glycemic control among us latinos lep