Impact of Interpretation Method on Clinic Visit Length

• Published in: Journal of general internal medicine : JGIM 2003-08, Vol.18 (8), p.634-638
• Main Authors: Fagan, Mark J., Diaz, Joseph A., Reinert, Steven E., Sciamanna, Christopher N., Fagan, Dylan M.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Civil rights; Communication Barriers; Female; Gender; Hospitals; Humans; Internal medicine; Interpreters; Language; Length of Stay; limited English proficiency; Male; medical interpreters; Medical sciences; Medical students; Medicine; Miscellaneous; Multivariate Analysis; Nurse practitioners; Original; Outpatient Clinics, Hospital - organization & administration; Patient satisfaction; Prevention and actions; Primary care; Professional-Patient Relations; Public health. Hygiene; Public health. Hygiene-occupational medicine; Rhode Island; Time and Motion Studies; Time Management - organization & administration; Time Management - psychology; visit time
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1046/j.1525-1497.2003.20701.x

OBJECTIVE: To determine the impact of interpretation method on outpatient visit length. DESIGN: Time–motion study. SETTING: Hospital‐based outpatient teaching clinic. PARTICIPANTS: Patients presenting for scheduled outpatient visits. MEASUREMENTS AND MAIN RESULTS: Over a 6‐week study period, a research assistant recorded the following information for consecutive patient visits: patient age, gender and insurance type; type of interpreter used (none, hospital interpreter, telephone interpreter or patient‐supplied interpreter); scheduled visit length; provider type (nurse practitioner; attending physician; resident in postgraduate year 1, 2 or 3, or medical student); provider gender; amount of time the patient spent in the examination room with the provider (provider time); and total time the patient spent in the clinic from check‐in to checkout (clinic time). When compared to patients not requiring an interpreter, patients using some form of interpreter had longer mean provider times (32.4 minutes [min] vs 28.0 min, P < .001) and clinic times (93.6 min vs 82.4 min, P = .002). Compared to patients not requiring an interpreter, patients using a telephone interpreter had significantly longer mean provider times (36.3 min vs 28.0 min, P < .001) and clinic times (99.9 min vs 82.4 min, P = .02). Similarly, patients using a patient‐supplied interpreter had longer mean provider times (34.4 min vs 28.0 min, P < .001) and mean clinic times (92.8 min vs 82.4 min, P = .027). In contrast, patients using a hospital interpreter did not have significantly different mean provider times (26.8 min vs 28.0 min, P = .51) or mean clinic times (91.0 min vs 82.4 min, P = .16) than patients not requiring an interpreter. CONCLUSION: In our setting, telephone and patient‐supplied interpreters were associated with longer visit times, but full‐time hospital interpreters were not.