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

Sponsor

Mathematica Policy Research, Inc. (Other)

Overall Status

Completed

CT.gov ID

NCT01041014

Collaborator

Robert Wood Johnson Foundation (Other)

447

Enrollment

Locations

Arms

Duration (Months)

223.5

Patients Per Site

14.9

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

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.

Condition or Disease	Intervention/Treatment	Phase
Language Discordance	Behavioral: Professional medical interpreter	N/A

Study Design

Study Type:

Interventional

Actual Enrollment :

447 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

None (Open Label)

Primary Purpose:

Health Services Research

Official Title:

Cost Effectiveness of Language Services in Hospital Emergency Departments

Study Start Date :

Oct 1, 2008

Actual Primary Completion Date :

Apr 1, 2009

Actual Study Completion Date :

Jan 1, 2010

Arms and Interventions

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).

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).

Outcome Measures

Primary Outcome Measures

Cost-effectiveness of in-person interpreters versus other language services [June 2009]

Secondary Outcome Measures

Satisfaction with ability to communicate [June 2009]

Eligibility Criteria

Criteria

Ages Eligible for Study:

N/A and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

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

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	CentraState Healthcare System	Freehold	New Jersey	United States	07728
2	Robert Wood Johnson University Hospital	New Brunswick	New Jersey	United States	08901

Sponsors and Collaborators

Mathematica Policy Research, Inc.
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