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

Cost Effectiveness of Language Services in Hospital Emergency Departments

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.

Study Overview

• Status: Completed
• Conditions: Language Discordance
• Intervention / Treatment: Behavioral: Professional medical interpreter

• Study Type: Interventional
• Enrollment (Actual): 447
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • New Jersey
    • Freehold, New Jersey, United States, 07728
      • CentraState Healthcare System
    • New Brunswick, New Jersey, United States, 08901
      • Robert Wood Johnson University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Professional medical interpreter; 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	Behavioral: Professional medical interpreter; 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.
No Intervention: Control, Usual Language Services; 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).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Cost-effectiveness of in-person interpreters versus other language services	June 2009

Secondary Outcome Measures

Outcome Measure	Time Frame
Satisfaction with ability to communicate	June 2009

Collaborators and Investigators

• Sponsor: Mathematica Policy Research, Inc.
• Collaborators: Robert Wood Johnson Foundation
• Investigators: Study Director: Ann D Bagchi, Ph.D., Mathematica Policy Research; Principal Investigator: Stacy Dale, MPA, Mathematica Policy Research; Principal Investigator: Robert Eisenstein, MD, University of Medicine and Dentistry of New Jersey

Study record dates

Study Major Dates

• Study Start: October 1, 2008
• Primary Completion (Actual): April 1, 2009
• Study Completion (Actual): January 1, 2010

Study Registration Dates

• First Submitted: December 28, 2009
• First Submitted That Met QC Criteria: December 29, 2009
• First Posted (Estimate): December 30, 2009

Study Record Updates

• Last Update Posted (Estimate): October 1, 2015
• Last Update Submitted That Met QC Criteria: September 29, 2015
• Last Verified: December 1, 2009

More Information

Terms related to this study

• Keywords: Satisfaction; Cost-effectiveness; Emergency Departments; Limited English proficiency; Language Discordance; Limited English proficient patients; Spanish-speaking patients
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Emergencies
• Other Study ID Numbers: 55879RWJF