A Cross-Sectional Analysis of Disparities in Biopsy Result Disclosure for Patients with Limited English Proficiency

Patients with limited English proficiency (LEP) receiving care from language-discordant providers experience worse outcomes in healthcare quality, safety, and satisfaction, so optimizing medical care for patients with LEP is an integral topic for quality improvement. At our institution, biopsy results are disclosed via telephone unless discussed during an appointment. In this retrospective cohort study, we aimed to quantify the relative lag time in telephone-based biopsy result disclosure when interpretation services were utilized compared to when they were not. A total of 12,372 patient interactions were analyzed; 250 patients (2.02%) required interpreters, and most of these patients spoke Spanish (196, 78.4%). Other languages spoken included Tagalog, Ukrainian, Serbian, Russian, Punjabi, Mandarin, Kurdish, Farsi, Nepali Arabic, and American Sign Language. The mean delay from provider result release to disclosure for patients who required an interpreter was 55.0 hours compared to 36.6 hours for those who did not, respectively (p<0.001). For those requiring a Spanish interpreter, this delay was 60.2 hours (p<0.001). For non-Spanish interpretation, the delay was 36.6 hours (p=0.99). Patients requiring a Spanish interpreter experienced increased mean wait times for receiving biopsy results compared to those who spoke English. Possible reasons include increased communication burden for clinicians when using interpreters, insufficient provider awareness of delays, and patient socioeconomic factors. Future research may analyze the impact of delayed result disclosure, optimal disclosure methods, and initiatives to reduce disparities in time to result disclosure for LEP patients.