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Abstract Details

Brain Barriers: Elucidating Complex Language-Based Barriers to Neurological Care in Limited-English Proficiency, Refugee, and Immigrant Populations
Health Care Disparities
P17 - Poster Session 17 (11:45 AM-12:45 PM)
11-003
This study aims to elucidate specific patient, provider, and resource-based variables that act as barriers to neurological care in limited-English proficiency (LEP) communities.

Neurological concerns are under-reported, under-addressed, and more difficult to manage in LEP populations due to factors such as language-based assessments, lack of access to care, inadequate translation services, and cultural stigma associated with seeking care, leaving this population vulnerable to poor follow-up and unnecessary sequelae of poorly managed disease.

LEP patients with neurological chief complaints and diagnoses were recruited for semi-structured interviews from the free clinic, emergency department, and outpatient neurology clinic. Interview transcripts were analyzed using qualitative coding to assess for common themes and unmet needs. A retrospective analysis of LEP neurology patients was also performed for each clinical setting over the past five years. Resident and attending physicians were anonymously surveyed on their comfort level interacting with and caring for LEP patients.
Retrospective analysis showed significant psychiatric and neurosurgical comorbidity among LEP neurology patients, emphasizing the need for integration and continuity of care in this population. Follow-up rates for outpatient referrals from the ED were lower for LEP patients than the general population, most notably for diagnoses of TBI, pain syndromes, and dementia. Patient interviews elucidated several prominent themes including hesitancy to admit questions, social barriers to prioritization of healthcare, confusion about condition etiologies and medication regimens, and low expectations for general care and outcomes. Physician surveys revealed variability among education and comfort with LEP patient care and a paucity of ideal translation services.
This multi-modal analysis of challenges faced by LEP patients seeking neurology care highlights the compounding effect language barriers can have on neurological status and quality of life. These findings provide important starting points for future investigations and pilot interventions to improve accessibility, quality, and continuity of neurological care for LEP patients.
Authors/Disclosures
Alexandra Miner
PRESENTER
Miss Miner has nothing to disclose.