Language-concordant care improves patient satisfaction compared with interpreter-mediated or discordant care

Narrative synthesis #

The strongest evidence is the Seible RCT — the first randomized comparison of direct language-concordant care versus professional-interpreter-mediated care — where direct-Spanish care raised the prespecified primary satisfaction endpoint (4.45 vs 4.09; P = .007) and every secondary overall-care and physician-communication domain measured immediately after the initial consultation. This converges with two weaker, non-randomized intervention designs: a pre-post inpatient career-ladder program (Marshall) and a Spanish-curriculum ED resident comparison (Stoneking). The principal qualification is durability: in Seible the advantage attenuated to nonsignificance at later treatment timepoints, which the authors read as interpreter-based care eventually catching up rather than concordance providing no benefit.

"Patients in the direct-Spanish arm reported top ratings (5 out of 5) with composite general satisfaction more frequently than the interpretive services arm (63% vs 25%; P = .001)." (Seible, 2021, p. 859)