Inpatient care experiences differ by preferred language within racial/ethnic groups

Health Serv Res. 2019 Feb;54 Suppl 1(Suppl 1):263-274. doi: 10.1111/1475-6773.13105. Epub 2019 Jan 6.


Objective: To describe differences in patient experiences of hospital care by preferred language within racial/ethnic groups.

Data source: 2014-2015 HCAHPS survey data.

Study design: We compared six composite measures for seven languages (English, Spanish, Russian, Portuguese, Chinese, Vietnamese, and Other) within applicable subsets of five racial/ethnic groups (Hispanics, Asian/Pacific Islanders, American Indian/Alaska Natives, Blacks, and Whites). We measured patient-mix adjusted overall, between- and within-hospital differences in patient experience by language, using linear regression.

Data collection methods: Surveys from 5 480 308 patients discharged from 4517 hospitals 2014-2015.

Principal findings: Within each racial/ethnic group, mean reported experiences for non-English-preferring patients were almost always worse than their English-preferring counterparts. Language differences were largest and most consistent for Care Coordination. Within-hospital differences by language were often larger than between-hospital differences and were largest for Care Coordination. Where between-hospital differences existed, non-English-preferring patients usually attended hospitals whose average patient experience scores for all patients were lower than the average scores for the hospitals of their English-preferring counterparts.

Conclusions: Efforts should be made to increase access to better hospitals for language minorities and improve care coordination and other facets of patient experience in hospitals with high proportions of non-English-preferring patients, focusing on cultural competence and language-appropriate services.

Keywords: patient assessment; quality of care (measurement); survey research.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Communication Barriers*
  • Cultural Competency*
  • Ethnicity / statistics & numerical data*
  • Female
  • Health Care Surveys
  • Health Equity
  • Hospitalization
  • Humans
  • Inpatients / psychology
  • Inpatients / statistics & numerical data*
  • Language
  • Male
  • Middle Aged
  • Minority Groups / statistics & numerical data*
  • Patient Satisfaction / ethnology
  • Pregnancy
  • Young Adult