The Role of Language Concordance in Pediatric Epilepsy Care in Austin, Texas

Recent research has shown significant disparities between the outcomes and experiences of patients who receive language concordant (in which patient and provider speak the same primary language) versus language discordant care. As demographic trends indicate an ever-increasing number of people in the US with limited English proficiency (LEP), the importance of providing language concordant care only increases. However, the mechanisms and extent of how language concordant care can impact healthcare experiences and outcomes, and how this varies based on specialty and patient demographics is still unknown. This paper includes 1) potential historical and cultural factors that can contribute to disparities for the LEP community, 2) a review of literature showing the potential consequences of the exclusion of language concordant care from pediatric and adult medicine, and 3) early findings of a pilot longitudinal study testing an entirely Spanish pediatric epilepsy clinic in Austin, Texas. In this study, patients receiving both language concordant and language discordant care were interviewed about their experience, perceptions, trust, and knowledge about epilepsy (amongst other factors). In addition, data from these patients’ electronic medical records was analyzed for patterns in physician documentation. The literature review revealed that significant disparities exist between Hispanic and non-Hispanic patient groups, and between English-proficient and LEP patients. Preliminary findings reinforce that language concordance can improve patient trust, quality of communication, and knowledge of epilepsy. Additionally, results indicate that language concordance can lead to more thorough documentation by providers, and be a valuable tool for improving patient knowledge and experience. Understanding the full scope of the impact of language concordance is critical to effective training, resource allocation, and policy-making decisions in the future.