دانلود رایگان مقاله انگلیسی تفسیر پزشکی در عمل سرپایی - NCBI 2018

ABSTRACT

This article provides an overview of the federal requirements related to providing interpreter services for non-English–speaking patients in outpatient practice. Antidiscrimination provisions in federal law require health programs and clinicians receiving federal financial assistance to take reasonable steps to provide meaningful access to individuals with limited English proficiency who are eligible for or likely to be encountered in their health programs or activities. Federal financial assistance includes grants, contracts, loans, tax credits and subsidies, as well as payments through Medicaid, the Children’s Health Insurance Program, and most Medicare programs. The only exception is providers whose only federal assistance is through Medicare Part B, an exception that applies to a very small percentage of practicing physicians. All required language assistance services must be free and provided by qualified translators and interpreters. Interpreters must meet specified qualifications and ideally be certified. Although the cost of interpreter services can be considerable, ranging from $45-$150/hour for in-person interpreters, to $1.25-$3.00/minute for telephone interpreters, and $1.95-$3.49/minute for video remote interpreting, it may be reimbursed or covered by a patient’s Medicaid or other federally funded medical insurance. Failure to use qualified interpreters can have serious negative consequences for both practitioners and patients. In one study, 1 of every 40 malpractice claims were related, all or in part, to failure to provide appropriate interpreter services. Most importantly, however, the use of qualified interpreters results in better and more efficient patient care.

Are the Costs Worth It?

Regardless of the federal and state requirements for language assistance or whether federally funded state programs provide reimbursement, providing appropriate interpretation services is a basic and key component of good patient care for individuals with LEP. Indeed, both the Institute of Medicine and the Joint Commission recognize the need for effective communication as an important aspect of high-quality care.56,57 Besides enhancing the quality of care and avoiding poor health outcomes for patients, there are potential negative consequences for health care providers that do not provide appropriate language assistance services. As noted earlier in the case example, malpractice lawsuits can result from adverse patient outcomes due to incorrect language interpretation. In fact, a report in 2010 evaluating 1,373 malpractice claims from 4 states found that 1 of every 40 claims were related, all or in part, to failure to provide appropriate language interpreter services.58 Some cases resulted in multi-million dollar malpractice settlements.59 Covered health care providers may also be subject to enforcement actions for failure to provide appropriate interpreter services.