Language Matters: Assessing the Role of Language Barriers in Patient-Reported Outcomes and Experiences in Germany

• In Event: 20820 - Section on Medical Sociology Roundtables
  In Refereed Roundtable (90 minute): Table 14. Healthcare Inequality

Abstract

Background
Patient-centered communication is crucial in providing quality cancer care, but language barriers can significantly hinder good communication and exacerbate existing disparities. In Germany, approximately 17% of households speak a non-German language, highlighting the need to address linguistic diversity in healthcare settings. Despite Germany's growing migrant population, research on the impact of language barriers on cancer care in Germany remains limited. This study investigates the role of language barriers in patient-reported outcomes (PROs) and patient-reported experience measures (PREMs) among native and non-native German speaking breast cancer patients. Additionally, the study examines the influence of hospital and regional linguistic diversity on these outcomes.
Methods
The Cologne Patient Questionnaire – Breast Cancer was used to measure information needs, communication experiences, and quality of life (physical functioning (EORTC-QLQ 30)). Linguistic diversity of hospitals was categorized by the proportion of non-native speaking patients. Multilevel logistic and linear regression models were used to analyze the data, adjusting for sociodemographic (education, age, health insurance status) and clinical variables (staging, type of surgery, chemotherapy).
Results
Data were collected from 4,968 breast cancer patients treated in 85 hospitals specialized in breast cancer care across a German federal state in 2021. Non-native speaking patients reported significantly higher information needs regarding their disease and worse physical functioning post-surgery compared to German native speakers, even after adjusting for relevant factors. In hospitals with higher linguistic diversity, however, the negative effect of non-native language status disappeared or was reduced, with non-native patients reporting better communication experiences.
Conclusion
Language barriers significantly impact patient care and outcomes, with non-native speaking patients facing greater challenges. Results suggest that hospitals with higher linguistic diversity may be better equipped to manage these barriers. This study highlights the necessity for targeted strategies and resources to improve communication in linguistically diverse healthcare settings, ensuring equitable care for all patients.

Authors

• Susan Lee, Siena College

• Holger Pfaff

• Lena Ansmann