Language is the means by which a physician and a patient exchange illness-related information, share beliefs about health and illness, and engage in shared decision making. When language barriers exist in provider–patient interactions, patients are likely to incur more cost. For example, patients with limited-English-proficiency (LEP) have higher use, longer stay, and more resource utilization (e.g., diagnostic testing) of emergency visits, and reduced use of preventive care and primary care services. Patients with LEP are significantly disadvantaged when interacting with providers, experiencing problematic care. They are less likely to receive follow-up appointments after an emergency visit, less likely to understand a health care provider's instructions, less likely to receive emotional support from their provider, and less satisfied with the quality of care (even in areas ...

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