Impact of interpretation method on clinic visit length

Abstract

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.