Impact of Language Barriers on Access to Healthcare Services by Immigrant Patients: A systematic review

Abstract

Background: Research has demonstrated lower access to healthcare services by immigrant patients in comparison to native people. Cultural and linguistic differences have been considered as main factors that impede this access and as barriers to creating an effective relationship between immigrant patients and health professionals.  Objective: The aim of this study was to better understand and synthesize the available evidence regarding the impact of immigrant patients’ language proficiency on access to health care. Methods: A systematic literature search was performed to identify studies published between January 2000 and January 2019 that examined the impact of language proficiency on access to and use of health services by immigrant patients. Only articles in English were included. Cross-referencing of the identified articles was also performed.  Results: A total of 140 publications was identified through online databases. In all 24 studies were reviewed, and the results were reported using four interrelated themes identified from the articles. These reports consistently showed a clear association between inadequate language ability and underuse of health care services, ineffective communication, and increased use of emergency care by immigrant patients. Identifying factors that can influence access to care, applying immigrant-friendly solutions such as provision of professional interpreters, and encouraging culturally and linguistically sensitive education may improve the quality of care and increase access to care. One study recommended utilisation of communication technologies such as telemedicine to bridge the communication gap and increase accessibility of healthcare services by immigrant patients.  Conclusions: All included studies indicated that language barriers hindered access to healthcare services. The data resulting from this study can update policy and practical solutions for language barriers on access to care by immigrant patients and provide an agenda for further investigations.