Gastric cancer is the fifth most common cancer in the world and disproportionately affects the East Asian population. It is crucial that medical interpretation is available for gastric cancer patients who may have Limited English Proficiency (LEP). Section 1557 of the Affordable Care Act in 2016 mandated use of qualified interpreters and efforts for meaningful access to LEP patients. Here we present the temporal trend in use of interpreters for gastric cancer patients in our single-institution, metropolitan hospital serving a large East Asian population.
Between January 2000 to June 2021, Tufts Medical Center patients with diagnosis of gastric cancer were identified based on ICD-10 code. Medical records lacking gastric cancer diagnosis, clinic documentation or diagnosis dates were excluded. Patient’s primary language was obtained by chart review. Medial interpreter use was based on documentation from patient’s initial oncology clinic note. Certified medical interpretation was defined as the use of licensed medical interpreters (excluded physician or family members’ interpretation). Patients were analyzed in 4 different time periods based on their diagnosis date: Years 2000-2005, 2006-2010, 2011-2015, 2016-2020+.
89 patients were chosen for analysis. The proportion of LEP patients ranged between 43.63 to 66.70%, with fewer LEP patients after 2010. There was a temporal increase in use of medical interpretation over time: 0%, 25%, 66.7%, 66.7%. The use of certified medical interpretation also increased from 0% to 45.8%. In the Asian language-speaking subset, the amount of medical interpretation service provided has risen from 0% to 70%. The proportion of certified medical interpretation also rose, however remains low at 55%.
There is a temporal increase in the use of medical interpreters, with improvement seen prominently in the Asian language LEP population. Further efforts should be made to increase the use of certified medical interpreters.