Patient-Physician Language Concordance and Hospitalizations for Diabetes-Related Complications: A Retrospective Cohort Study

OBJECTIVE Patient-physician language concordance is associated with higher quality and safer health care services. However, little is known about the impact of patient-physician language concordance on long-term health outcomes. The objective of this study was to examine the relationship between patient-physician language concordance and hospitalizations for diabetes-related complications. RESEARCH DESIGN AND METHODS This retrospective cohort study was conducted among adults with self-reported diabetes using the Canadian Community Health Survey (CCHS), a nationally representative cross-sectional survey of Canadian residents, from 1 January 2003 to 31 December 2014. Patient-physician language concordance was defined as agreement between respondents’ primary home language and the language spoken with their regular medical doctor. Hospitalizations for diabetes-related complications were identified using hospitalization and vital statistics administrative data within 10 years of CCHS survey completion. RESULTS We studied a total of 33,965 respondents, including 30,980 Anglophone, 1,305 Francophone, and 1,680 Allophone (i.e., other language) patients. Allophone patients who received language-concordant care were 39% less likely to be hospitalized for a diabetes-related complication compared with Allophone patients who received language-discordant care (hazard ratio [HR] 0.61; 95% CI 0.45–0.82); this difference was primarily driven by hospitalizations for cardiovascular events (HR 0.50; 95% CI 0.36–0.70). For Francophone patients, the association between patient-physician language concordance and hospitalizations for diabetes-related complications was not statistically significant (HR 0.87; 95% CI 0.65–1.15). CONCLUSIONS Patient-physician language concordance was associated with a lower risk of hospitalization for diabetes-related complications among Allophone patients. These findings highlight the importance of language-concordant care to improve the long-term health of Allophone patients living with diabetes.