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Specialty Care Utilization Among Adults with Limited English Proficiency
Jessica Himmelstein1,2, Christopher Cai3,4, David U Himmelstein5,4,6
1Department of Medicine, Cambridge Health Alliance, Cambridge, MA, USA. jhimmelstein@challiance.org.
Journal of General Internal Medicine
|March 29, 2022
Summary
Patients with limited English proficiency (LEP) have significantly fewer outpatient specialty visits compared to English proficient (EP) individuals. These disparities are most pronounced in medical and surgical subspecialties, highlighting critical access barriers.
Area of Science:
- Health Services Research
- Health Disparities
- Medical Sociology
Background:
- Limited English proficiency (LEP) presents significant barriers to healthcare access.
- Previous research has not comprehensively examined language-related disparities in outpatient specialty care utilization.
Purpose of the Study:
- To compare outpatient visit rates to physicians across 28 specialties between individuals with LEP and English proficiency (EP).
Main Methods:
- Analysis of nationally representative data from the Medical Expenditure Panel Survey (2013-2018).
- Multivariable negative binomial regression was used to compare annual per capita visit rates.
- Adjustments were made for age, sex, and self-reported health status.
Main Results:
- Patients with LEP were underrepresented in 26 of 28 specialties.
- Significant disparities were observed in pulmonology, orthopedics, otolaryngology, and psychiatry.
- Disparities were larger for medical subspecialties and surgical specialties compared to primary care.
Conclusions:
- Patients with LEP are significantly underrepresented in most outpatient specialty practices.
- Language barriers impede access to essential medical and surgical subspecialty care.
- Addressing language barriers is crucial for equitable healthcare access for LEP populations.
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