[Language barriers and potentially avoidable healthcare and economic consequences in migrant populations: an exploratory study].

OBJECTIVE

To explore how communication problems in language-discordant clinical encounters may affect the transmission of clinical information and be associated with potentially avoidable healthcare and economic consequences.

METHOD: Exploratory qualitative study of mediated consultations. From a corpus of 68 video-recorded consultations, 25 interactions considered typical and information-rich had been purposively transcribed. After excluding non-codable records and duplicate versions, 14 unique interactions were analysed. Interactions containing a clinically relevant communication problem and a plausible healthcare consequence were identified, and informative contrast cases were selected. Linguistic checking involved research staff competent in each language.

RESULTS

Four interactions met the criterion for a clinically relevant communication problem: a laterality error and terminological ambiguity, partial transmission of vaccination risk-benefit information, uncertainty about technical terms and procedure timing, and attenuated transmission of pain. Three contrast interactions preliminarily showed practices that coincided with prevention or repair of transmission problems.

CONCLUSIONS

The interactions describe plausible mechanisms through which inadequate intercultural mediation or interpreting may compromise understanding, safety and healthcare efficiency. The design does not allow causal effects or costs to be estimated. Prospective studies linking mediation to healthcare use, outcomes and resource use are required.