{"id":17875,"date":"2021-03-15T18:46:50","date_gmt":"2021-03-15T18:46:50","guid":{"rendered":"https:\/\/goglobalstd.wpengine.com\/5-keys-to-understanding-the-lep-patients-healthcare-services-landscape-in-the-us\/"},"modified":"2024-11-15T17:51:01","modified_gmt":"2024-11-15T17:51:01","slug":"5-keys-to-understanding-the-lep-patients-healthcare-services-landscape-in-the-us","status":"publish","type":"post","link":"https:\/\/www.goglobal-consulting.com\/fr\/5-keys-to-understanding-the-lep-patients-healthcare-services-landscape-in-the-us\/","title":{"rendered":"5 keys to understanding the LEP patients healthcare services landscape in the US"},"content":{"rendered":"\n

Imagine a patient who doesn\u2019t speak English and runs into a hospital with a severe wound after a car crash. From the moment the patient enters the hospital, any delay in communication could result in a life-threatening situation. All the treatment decisions depend on interpreting, and the clock is ticking.\u00a0<\/p>\n\n

Let’s suppose now that the language the patient speaks is fairly common, and there\u2019s a person in the building who speaks that language too and offers to volunteer an interpreter. It sounds like a solution, right? But if that person doesn\u2019t have the proper training, that intervention could rapidly become a risk for the patient\u2019s confidentiality and safety as well.\u00a0<\/p>\n\n

What are hospitals expected to do in these situations? What are the obligations the healthcare community has towards a patient with a limited ability to read, speak, write, or understand English? And what kind of solutions can be implemented for service improvement?<\/p>\n\n

In this article, we\u2019ll cover briefly and concisely the key factors involved in these types of situations, regarding its legal, social, and linguistic perspectives: <\/p>\n\n

  1. The number of persons with limited English skills living in the United States is growing.<\/a><\/li>
  2. The increasing diversity calls for a political approach that addresses the change of sociocultural environments. <\/a><\/li>
  3. The legal framework demands federal assisted entities to guarantee their services and benefits for every person in the United States. <\/a><\/li>
  4. On the healthcare system, the challenges concern an effective assessment of the local communities\u2019 demographics and the resources of each provider to meet their needs.<\/a><\/li>
  5. As communities become more diverse, the language services industry follows, creating solutions with a broader reach.<\/a><\/li>
  6. Three takeaways<\/a><\/li><\/ol>\n

    <\/a><\/p>\n\n

    The number of persons with limited English skills living in the United States is growing.<\/strong><\/h2>\n\n

    Individuals aged 5 and older who have a limited ability to read, speak, write, or understand English are considered Limited English Proficient or \u00ab\u00a0LEP.\u00a0\u00bb The number and diversity of LEP speakers in the United States has significantly increased\u00a0 in the last decades, explained by the raising of immigrant populations with a significant part coming from countries where English is not an official language. According to 2018 data, more than 25.6 million people were LEP, accounting for 9 percent of the overall US population.<\/a><\/p>\n\n

    Limited language proficiency is related to low health literacy, a common phenomenon that affects 40% of the US population.<\/a> Among other factors as lower socioeconomic status, long-term illness or disability, and old age, a language barrier denies patients the possibility to obtain, understand, and act on health information.<\/p>\n\n

    According to the 2018 US Census Bureau data, the highest concentrations of LEP individuals reside in the six traditional immigrant-destination states: California, Texas, New York, Florida, Illinois, and New Jersey. Spanish is the predominant language spoken (62 percent), followed by Chinese (7 percent), Vietnamese (3 percent), Korean (2 percent), and Tagalog (2 percent). Close to 76 percent of the LEP population communicates in one of these five languages. <\/p>\n\n

    Socioeconomically speaking, the overall LEP population (immigrant and US-born) was less educated and more likely to live in poverty than the English-proficient population. In 2015, 45 percent of all LEP individuals aged 25 and older lacked a high school diploma (compared to 9 percent of the English-proficient population), and about 23 percent lived in households with an annual income below the official federal poverty line.\u00a0<\/p>\n\n

    On health-related issues, and as Glenn Flores points out<\/a>, \u201cLEP patients often defer needed medical care, have a higher risk of leaving the hospital against medical advice, are less likely to have a regular health care provider, and are more likely to miss follow-up appointments, to be non-adherent with medications and to be in fair\/poor health.\u201d<\/p>\n\n

    \"\"<\/figure>\n

    <\/a><\/p>\n\n

    The increasing diversity calls for a political approach that addresses the change of sociocultural environments.\u00a0<\/strong><\/h2>\n\n

    The demographic impact of an increasing population with limited English skills concerns the entire social fabric and presents a series of questions about the ability of the political, economic and legal structures to adapt to this evolving scenario.\u00a0<\/p>\n\n

    With increased diversity, social structures and behaviors face the challenge to ensure that everyone in the nation, whether they speak English proficiently or not, has equal access to the available systems.\u00a0<\/p>\n\n

    The labor market, the educational system, the legal system, and the healthcare and social assistance services deal with this issue on a daily basis and constantly seek more efficient management strategies. <\/p>\n

    <\/a><\/p>\n\n

    The legal framework demands federal assisted entities to guarantee their services and benefits for every person in the United States.\u00a0<\/strong><\/h2>\n\n

    This obligation is supported by a series of laws, national and local. En ce qui concerne l’acc\u00e8s linguistique, les pierres angulaires sont le titre VI de la loi sur les droits civils de 1964 et le d\u00e9cret pr\u00e9sidentiel 13166.\u00a0<\/p>\n\n

    Le titre VI de la loi sur les droits civils de 1964 stipule que\u00a0<\/p>\n\n

    \u00ab\u00a0Aucune personne aux \u00c9tats-Unis ne sera, pour des raisons de race, de couleur ou d’origine nationale, exclue de la participation, priv\u00e9e des avantages ou soumise \u00e0 une discrimination dans le cadre d’un programme ou d’une activit\u00e9 b\u00e9n\u00e9ficiant d’une aide financi\u00e8re f\u00e9d\u00e9rale\u00a0\u00bb<\/em><\/p><\/blockquote>\n\n

    L’objectif de ce titre est d’interdire la discrimination. Elle exige des services de police, des h\u00f4pitaux, des autorit\u00e9s charg\u00e9es du logement, des centres de ch\u00f4mage et de tout programme ou activit\u00e9 b\u00e9n\u00e9ficiant d’un financement f\u00e9d\u00e9ral qu’ils offrent \u00e0 tous les habitants un acc\u00e8s significatif et \u00e9gal \u00e0 leurs services et avantages.<\/p>\n\n

    En 2000, le d\u00e9cret pr\u00e9sidentiel 13166 a \u00e9t\u00e9 publi\u00e9 pour \u00e9tendre la port\u00e9e du titre VI de la loi sur les droits civils, en abordant la question de la langue. L’objectif de la nouvelle norme, intitul\u00e9e \u00ab\u00a0Improving access to services for persons with limited English proficiency\u00a0\u00bb, est \u00ab\u00a0d’am\u00e9liorer l’acc\u00e8s aux programmes et activit\u00e9s men\u00e9s et soutenus par le gouvernement f\u00e9d\u00e9ral pour les personnes qui, en raison de leur origine nationale, ont une ma\u00eetrise limit\u00e9e de l’anglais (LEP)\u00a0\u00bb.<\/a><\/p>\n\n

    Pour atteindre son objectif, elle demande aux agences f\u00e9d\u00e9rales de \u00ab\u00a0d\u00e9velopper et mettre en \u0153uvre un syst\u00e8me permettant aux personnes LEP d’acc\u00e9der de mani\u00e8re significative \u00e0 ces services, en accord avec la mission fondamentale de l’agence et sans l’entraver ind\u00fbment\u00a0\u00bb Cela signifie que les personnes qui parlent le fran\u00e7ais ou l’anglais doivent avoir un acc\u00e8s significatif aux programmes et activit\u00e9s men\u00e9s et financ\u00e9s par le gouvernement f\u00e9d\u00e9ral.<\/p>\n\n

    \"\"<\/figure>\n

    <\/a><\/p>\n\n

    En ce qui concerne le syst\u00e8me de soins de sant\u00e9, les d\u00e9fis concernent une \u00e9valuation efficace de la d\u00e9mographie des communaut\u00e9s locales et des ressources de chaque prestataire pour r\u00e9pondre \u00e0 leurs besoins.<\/strong><\/h2>\n\n

    Selon le cadre juridique d\u00e9crit ci-dessus, une fois que les prestataires de soins de sant\u00e9 acceptent des fonds f\u00e9d\u00e9raux tels que les paiements Medicaid, ils sont tenus de fournir un acc\u00e8s linguistique \u00e0 tous leurs patients.<\/p>\n\n

    Les modalit\u00e9s d’application de ces lois varient d’un \u00c9tat \u00e0 l’autre. Certains \u00c9tats ont adopt\u00e9 une ou plusieurs lois sur l’acc\u00e8s aux langues dans les \u00e9tablissements de soins de sant\u00e9, la Californie \u00e9tant l’\u00c9tat qui compte le plus grand nombre de lois. Certains \u00c9tats \u00e9tendent leur cadre juridique \u00e0 des sujets\/domaines sp\u00e9cifiques tels que les formulaires d’admission, les risques d’avortement, les institutions psychiatriques, la documentation sur le VIH, etc.<\/p>\n\n

    Chaque minist\u00e8re f\u00e9d\u00e9ral dispose d’un bureau des droits civils (Office of Civil Rights, OCR). Les OCR sont charg\u00e9s de veiller \u00e0 ce qu’il n’y ait pas de discrimination dans les programmes de leur d\u00e9partement et ils ont le pouvoir d’enqu\u00eater sur les plaintes relatives aux barri\u00e8res linguistiques, d’entreprendre des audits et de retenir les fonds f\u00e9d\u00e9raux en cas de non-conformit\u00e9.\u00a0<\/p>\n\n

    En r\u00e9ponse au d\u00e9cret 13166, l’OCR a publi\u00e9 un document d’orientation pour aider les prestataires de soins de sant\u00e9 et les autres programmes financ\u00e9s par le gouvernement f\u00e9d\u00e9ral \u00e0 respecter leurs nouvelles obligations. Dans le cadre de ce guide, quatre facteurs ont \u00e9t\u00e9 d\u00e9finis pour aider \u00e0 prendre des d\u00e9cisions sur l’\u00e9tendue des services linguistiques \u00e0 fournir. Ces facteurs sont les suivants :<\/p>\n\n

    1. Nombre ou proportion de personnes LEP dans la communaut\u00e9. Plus il y a de personnes parlant une langue dans la communaut\u00e9, plus il y aura d’assistance linguistique dans cette langue.<\/li>
    2. Fr\u00e9quence des contacts entre le b\u00e9n\u00e9ficiaire et les LEP. Plus les contacts sont fr\u00e9quents, plus le besoin de services linguistiques est important.<\/li>
    3. Nature et importance du service pour le LEP. Plus le service ou le programme du b\u00e9n\u00e9ficiaire est important (plus le risque est grand si la personne ne peut pas communiquer efficacement), plus il est probable que des services linguistiques soient n\u00e9cessaires. Cela implique de meilleurs d\u00e9lais et une meilleure qualit\u00e9 de service.<\/li>
    4. Ressources disponibles et co\u00fbt. Le niveau des services linguistiques requis doit correspondre au budget du b\u00e9n\u00e9ficiaire. Mais les limitations \u00e9conomiques doivent \u00eatre bien \u00e9tay\u00e9es avant d’utiliser ce facteur comme raison de limiter l’assistance linguistique.\u00a0<\/li><\/ol>\n

      <\/a><\/p>\n\n

      \u00c0 mesure que les communaut\u00e9s se diversifient, l’industrie des services linguistiques suit le mouvement, en cr\u00e9ant des solutions de plus grande port\u00e9e.<\/strong><\/h2>\n\n

      Pour r\u00e9pondre \u00e0 la question initiale sur les ressources dont disposent les communaut\u00e9s de soins de sant\u00e9 pour les patients atteints de LEP, nous devons nous pencher sur la gamme de solutions linguistiques disponibles. La premi\u00e8re \u00e9tape pour s\u00e9lectionner une solution ad\u00e9quate consiste \u00e0 identifier les langues parl\u00e9es par les patients LEP. La seconde consiste \u00e0 \u00e9valuer les facteurs cl\u00e9s de la communaut\u00e9 \u00e0 laquelle participent ces patients (nombre de personnes LEP ayant besoin d’aide, fr\u00e9quence des services, nature et importance des services dont ils ont besoin, ressources et co\u00fbts).\u00a0\u00a0<\/p>\n\n

      Une fois les donn\u00e9es recueillies et la situation \u00e9valu\u00e9e, il est temps de choisir la solution linguistique la plus appropri\u00e9e pour un traitement r\u00e9ussi. Aujourd’hui, il existe un large \u00e9ventail de strat\u00e9gies et de ressources, qui vont du travail b\u00e9n\u00e9vole \u00e0 un fournisseur de services linguistiques de bout en bout.\u00a0<\/p>\n\n

      B\u00e9n\u00e9voles de la communaut\u00e9. <\/strong>Dans les petites communaut\u00e9s disposant d’un budget limit\u00e9, l’institution peut b\u00e9n\u00e9ficier de l’aide de membres du personnel multilingues. Dans ce cas, il est pr\u00e9f\u00e9rable de travailler avec des personnes qui ont un certain niveau de comp\u00e9tence dans le domaine de l’interpr\u00e9tation ou d’envisager d’investir dans une formation.<\/p>\n\n

      Services d’interpr\u00e9tation \u00e0 la demande. <\/strong>Pour les centres de soins de sant\u00e9 ayant un faible taux de patients LEP, un interpr\u00e8te travaillant \u00e0 la demande sera la meilleure solution. L’interpr\u00e9tation par t\u00e9l\u00e9phone (OPI) et l’interpr\u00e9tation vid\u00e9o \u00e0 distance (VRI) sont des services qui continuent \u00e0 se d\u00e9velopper en raison de leur rapidit\u00e9 et de leur praticit\u00e9. Ils sont normalement factur\u00e9s \u00e0 la minute et sont abordables car l’interpr\u00e8te peut se trouver n’importe o\u00f9. Les interpr\u00e8tes de ces r\u00e9seaux sont certifi\u00e9s HIPAA<\/a> et connaissent la terminologie m\u00e9dicale. Pour les situations plus d\u00e9licates, o\u00f9 chaque geste et chaque d\u00e9tail sont cruciaux, l’interpr\u00e9tation en personne sera la bonne approche.<\/p>\n\n

      Un programme complet \u00e0 haut volume d\u00e9velopp\u00e9 par un fournisseur de services linguistiques. <\/strong>Lorsque l’\u00e9tablissement de soins de sant\u00e9 re\u00e7oit un grand nombre de patients LEP ou une demande de langues multiples, il est recommand\u00e9 de s\u00e9lectionner un prestataire de services linguistiques. La signature d’un accord de niveau de service (SLA) garantit des co\u00fbts r\u00e9duits et une r\u00e9ponse rapide et adapt\u00e9e, incluant non seulement des services d’interpr\u00e9tation, mais aussi des traductions de formulaires et de documents, ainsi que la localisation de sites web, de brochures d’information pour les patients (PIL), d’applications pour les patients, etc. Ce type d’approche consultative couvre \u00e9galement l’avantage (souvent m\u00e9connu) de la cr\u00e9ation de bases terminologiques et de guides de style, deux ressources linguistiques qui permettent de gagner du temps et de l’argent, et d’optimiser la communication sur tous les canaux.<\/p>\n

      <\/a><\/p>\n\n

      Trois points \u00e0 retenir<\/strong><\/h2>\n\n

      1. <\/strong>The increasing number of persons with limited English skills living in the US requires the social and political structures to evolve in order to ensure access to public systems to every member of the community. To fulfill this objective, the legal framework not only must prevent discrimination but also ensure real resources to reach the non-English speakers.<\/p>\n\n

      2.<\/strong> For the healthcare providers that receive federal funding, the main challenge is to add interpreters to their clinical practices to guarantee an equal quality treatment for LEP patients. To assess the level of linguistic resources that a provider must include in their service, they must take into account the demographics of the community (number of LEP persons, languages they speak, frequency of their service requests) and the resources available to the institution.\u00a0<\/p>\n\n

      3.<\/strong> The healthcare provider can opt for various strategies to meet its community linguistic needs, in a range that goes from including community volunteers as interpreters to hiring a language service provider. Like any other global service, the language industry has evolved to create diverse and customized responses, and there are plenty of tailored solutions for every community, scope, and budget.\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"

      Imagine a patient who doesn\u2019t speak English and runs into a hospital with a severe wound after a car crash. From the moment the patient enters the hospital, any delay in communication could result in a life-threatening situation. All the treatment decisions depend on interpreting, and the clock is ticking.\u00a0 Let’s suppose now that the […]<\/p>\n","protected":false},"author":2,"featured_media":17879,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"content-type":"","footnotes":""},"categories":[73],"tags":[76],"class_list":["post-17875","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized-fr","tag-translation-fr"],"yoast_head":"\n5 keys to understanding the LEP patients healthcare services landscape in the US · Go Global<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.goglobal-consulting.com\/fr\/5-keys-to-understanding-the-lep-patients-healthcare-services-landscape-in-the-us\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"5 keys to understanding the LEP patients healthcare services landscape in the US · Go Global\" \/>\n<meta property=\"og:description\" content=\"Imagine a patient who doesn\u2019t speak English and runs into a hospital with a severe wound after a car crash. 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