Language concordance predicted higher patient-rated communication scores (beta=-0.182, p=0.03)

Description #

In the OLS survey model, language-concordant participants rated the quality of communication significantly higher than discordant participants (concordance β = −0.182, p = 0.03, on the concordant:discordant coding); the patient's native language was not a significant predictor of communication scores (β = 0.126, p = 0.132) (Table 5). Communication quality tracked concordance specifically, not whether the family spoke Spanish.

"Language concordant participants rated higher scores of communication (p = 0.03)." (Jaramillo, 2016, p. 672)

Methods Context #

What? #ⓘ

The observable: the participant's 5-point Likert rating on the communication-quality survey domain.

"Participants indicated their level of agreement with a series of 15 questions using a 5-point Likert scale from 1 (strongly disagree/very negative/never) to 5 (strongly agree/very positive/always)." (Jaramillo, 2016, p. 672)

How? #ⓘ

A surgery-specific post-visit satisfaction survey (modeled after validated instruments) analyzed by OLS regression using language concordance and patient's language as explanatory variables. 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….

"Regression modeling was used to determine the factors associated with survey results using language concordance and patient's language as explanatory variables." (Jaramillo, 2016, p. 672)

Who? #ⓘ

The 156-family cohort of pediatric surgery patients at a single academic children's hospital, surveyed after their visit.

"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 #

Table 5 reports both coefficients for Communication: language concordance −0.182 (p = 0.03) and patient's language 0.126 (p = 0.132). The negative concordance coefficient reflects the concordant:discordant coding (discordant = lower communication scores).

Caveats #

• Single urban academic institution with a small, demographically narrow Spanish-speaking pediatric surgery sample All participants were pediatric surgery patients at a single institution in urban Northern California, whose clinician and patient demographics may differ from other settings, and the small, single-hospital sample may not represent the diversity of the Spanish-speaking population. These features constrain external validity: the observed concordance effects may not generalize to other surgical subspecialties, geographic regions, LEP language groups, or health systems.
• Convenience sample with non-randomized assignment to concordant vs discordant care and baseline SES imbalance The study used a convenience sample and did not randomize Spanish-LEP patients to the concordant versus discordant group; group assignment followed clinic scheduling/availability, so there was no control over which families received concordant versus interpreter-mediated care. In addition, the English-speaking and Spanish-speaking groups differed significantly at baseline in education and income (though the two Spanish-speaking groups were demographically similar). These features raise the possibility of selection bias and residual confounding in the association between concordance and question-asking / satisfaction, even though the multivariable model adjusted for education, native language, and new-patient status.