TY - JOUR
T1 - Assessing the relationship between language proficiency and asthma morbidity among inner-city asthmatics
AU - Wisnivesky, Juan P.
AU - Kattan, Meyer
AU - Evans, David
AU - Leventhal, Howard
AU - Musumeci-Szabó, Tamara J.
AU - McGinn, Thomas
AU - Halm, Ethan A.
PY - 2009/2
Y1 - 2009/2
N2 - Background: Patient-provider communication is essential for high-quality asthma care. The objective of this study was to assess the potential relationship of language barriers with outcomes of inner-city asthmatics. Research Design: We interviewed a prospective cohort of 318 adults with persistent asthma receiving care at 2 large inner-city clinics. Patients were classified into 3 groups according to their English proficiency; non-Hispanics (all native English speakers), Hispanics proficient in English, and Hispanics with limited English proficiency. Data on asthma control (Asthma Control Questionnaire), resource utilization, and asthma-related quality of life (Asthma Quality of Life Questionnaire) were collected at 1 and 3 months of enrollment. Univariate and multiple regression analyses were used to compare asthma morbidity and quality of life according to the patients' level of English proficiency. Results: Overall, 44% of patients were non-Hispanics, 38% were Hispanics proficient in English, and 18% were Hispanics with limited English proficiency. Unadjusted, stratified, and multivariate analyses showed a significant association between limited proficiency and poorer asthma control, increased resource utilization, and lower quality of life scores after controlling for potential confounders (P < 0.05 for all comparisons). Additionally, limited English proficiency was associated with increased worries about side effects or becoming addicted to inhaled corticosteroids, beliefs that asthma is an acute disease, decreased self-efficacy, and lower adherence rates. Conclusions: Inner-city asthmatics with limited English proficiency have significantly poorer asthma control, higher rates of resource utilization, and a lower quality of life. Further research is necessary to understand the mechanisms underlying this association.
AB - Background: Patient-provider communication is essential for high-quality asthma care. The objective of this study was to assess the potential relationship of language barriers with outcomes of inner-city asthmatics. Research Design: We interviewed a prospective cohort of 318 adults with persistent asthma receiving care at 2 large inner-city clinics. Patients were classified into 3 groups according to their English proficiency; non-Hispanics (all native English speakers), Hispanics proficient in English, and Hispanics with limited English proficiency. Data on asthma control (Asthma Control Questionnaire), resource utilization, and asthma-related quality of life (Asthma Quality of Life Questionnaire) were collected at 1 and 3 months of enrollment. Univariate and multiple regression analyses were used to compare asthma morbidity and quality of life according to the patients' level of English proficiency. Results: Overall, 44% of patients were non-Hispanics, 38% were Hispanics proficient in English, and 18% were Hispanics with limited English proficiency. Unadjusted, stratified, and multivariate analyses showed a significant association between limited proficiency and poorer asthma control, increased resource utilization, and lower quality of life scores after controlling for potential confounders (P < 0.05 for all comparisons). Additionally, limited English proficiency was associated with increased worries about side effects or becoming addicted to inhaled corticosteroids, beliefs that asthma is an acute disease, decreased self-efficacy, and lower adherence rates. Conclusions: Inner-city asthmatics with limited English proficiency have significantly poorer asthma control, higher rates of resource utilization, and a lower quality of life. Further research is necessary to understand the mechanisms underlying this association.
KW - Asthma
KW - Hispamcs
KW - Language
KW - Outcomes
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U2 - 10.1097/MLR.0b013e3181847606
DO - 10.1097/MLR.0b013e3181847606
M3 - Article
C2 - 19169126
AN - SCOPUS:59049098362
SN - 0025-7079
VL - 47
SP - 243
EP - 249
JO - Medical Care
JF - Medical Care
IS - 2
ER -