Clinical visit length did not differ across language-concordance groups (8.65 vs 10.06 vs 9.29 min, p=0.351)

Description #

The mean length of the clinical visit with the surgeon did not differ significantly across the three concordance groups (concordant-English 8.65 min, LEP concordant-Spanish 10.06 min, LEP discordant-interpreter 9.29 min; ANOVA p = 0.351), and all pairwise comparisons were non-significant (Tables 2 and 3). This is a null result: concordance did not shorten or lengthen the encounter. The authors caution that because interpreter speaking time is included in the discordant visits, equal total length likely masks less actual patient–provider communication.

"The length of clinic visit with the surgeon was similar among the groups (Tables 2 and 3)." (Jaramillo, 2016, p. 672)

Methods Context #

What? #ⓘ

The observable: the total length (in minutes) of the clinical encounter with the surgeon, measured from the audio recording.

"four trained research assistants listened to the audio recording of the encounter and measured the number of patient-asked questions related to eliciting medical information and the length of the visit with the surgeon." (Jaramillo, 2016, p. 672)

How? #ⓘ

One-way ANOVA and pairwise t-tests on the audio-derived visit-length measure across concordance groups. The concordant-Spanish arm received care via A-0013ArtifactA-0013Initial AI draftThe Hispanic Clinic for Pediatric SurgeryA dedicated language-concordant outpatient clinic model at Lucile Packard Children's Hospital (Stanford) in which Spanish-speaking LEP families of pediatric surgery patients are cared for directly by a fluent Spanish-spe….

"We examined comparisons of continuous variables among the three exposure groups using one-way analysis of variance and pairwise analysis using student's t-tests." (Jaramillo, 2016, p. 672)

Who? #ⓘ

The 156-family cohort at a single academic children's hospital: concordant-English (57), LEP concordant-Spanish (52), LEP discordant-interpreter (47).

"A total of 156 families were enrolled including 57 concordant-English, 52 LEP concordant-Spanish and 47 LEP discordant families." (Jaramillo, 2016, p. 672)

Other Notes #

Mean visit lengths and the ANOVA p-value (0.351) are in Table 2; the non-significant pairwise differences (all p > 0.3) are in Table 3. See the qualifying caveat on interpreter speaking-time confounding the equal-length result.

Caveats #

• Equal visit length likely masks reduced patient-provider communication because interpreter speaking time is included The null finding of equal visit length across concordance groups must be interpreted with caution: the discordant-visit duration includes minutes when the interpreter (rather than the patient or physician) was speaking. Equal total length therefore likely conceals that patients and physicians were actually speaking less during interpreter-mediated visits, meaning direct patient–provider communication was reduced even though the clock time was comparable.