Study reveals gaps in health care across Canada for patients with limited English

VANCOUVER – A Toronto researcher says hospitals across Canada should provide professional interpreters after a study revealed gaps in health care for patients with limited English skills.

Dr. Shail Rawal, an assistant professor in the Department of Medicine at the University of Toronto, led a study with data from all patients discharged from two hospitals in the city with either the acute conditions pneumonia and hip fracture, or heart failure and chronic obstructive lung disease.

The study, which looked at 10,000 people between 2008 and 2016, found patients with limited English proficiency are more likely to return to the emergency room or be readmitted to hospital because they may not have understood instructions on taking medication compared with those who know the language and were discharged with similar health concerns.

Rawal, who is also a staff physician at the University Health Network of hospitals in Toronto, says patients who had limited English proficiency and heart failure or COPD were more likely to be readmitted to hospital in the 30 or 90 days after discharge.

She says the study, recently published in the Journal of the American Medical Association, found there was no difference in return to hospital for patients with pneumonia or hip fracture, likely because those conditions require surgery and rehab but not counselling by a doctor that could lead to misunderstanding by patients who lack English skills.

Rawal says medical errors can happen and patients may be misdiagnosed when they can’t communicate well enough with doctors so it’s important for hospitals across Canada, not just in the bigger cities, to provide professional interpreters at the bedside.