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Am J Manag Care. 2008 Jul;14(7):417-26.

Language disparities and timely care for children in managed care Medicaid.

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Center for Child Health Studies, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 133 Brookline Ave, 6th Fl, Boston, MA 02215, USA.



To examine the relationship of race/ethnicity, language, communication with providers, and interpreter use with timeliness of illness and routine care for children in managed care Medicaid.


Cross-sectional study using data from the Consumer Assessment of Health Plans Survey, which was administered to parents of children less than 15 years of age in Washington State managed care Medicaid in 2000.


Predictors of interest were child's race/ethnicity, parent's primary language at home, difficulty communicating with the child's providers because of language, and need and use of interpreters. The primary outcomes were how often (always, usually, sometimes, or never) the child received illness and routine care as soon as wanted. Analyses used multivariate ordered logistic regression and model-based direct adjustment.


A total of 5142 children were included. In adjusted analyses, children received illness and routine care significantly less often than wanted if the parent's primary language at home was not English; the parent ever had difficulty communicating with the provider; and the parent needed but did not always get an interpreter.


Language barriers were associated with decreased timeliness of care for children in managed care Medicaid.

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