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Patients with limited English proficiency (LEP) face disparities in using telehealth. While research has focused on access, attention to patient experience is essential. Patients with LEP have worse experience with in-person care. They examined differences in telehealth access and experience between patients with LEP and patients with English proficiency (EP) in California.We analyzed the 2021 adult data from California Health Interview Survey (CHIS), which is conducted in 6 languages. The Brigham and Women's Hospital Institutional Review Board deemed this cross-sectional study exempt from review and waived informed consent because publicly available data were used. They followed the STROBE reporting guideline.Study exposure was LEP, defined as speaking English not well or not at all. Study outcomes were telehealth use and visit experience. For telehealth use, CHIS participants were asked whether they had used video or telephone telehealth in the past 12 months (eAppendix in Supplement).
The study included 24 453 participants (10 735 males [weighted 49%], 13 718 females [weighted 51%]), representing a population of 29 649 837. Patients with LEP accounted for 9% of participants and 7% of telehealth users. Telehealth users with LEP differed significantly from users with EP across most covariates . Among telehealth users, patients with LEP accounted for 6.8% of video visit users (387, representing a population of 840 764) and 8.1% telephone visit users (484, representing a population of 1 021 909).For patients with LEP, they found not only telehealth access disparities but also worse video visit experience. Additionally, characteristics of video and telephone visit users differed by English proficiency. Worse video visit experience may be associated with challenges in integrating interpreters into telehealth visits or perceived effectiveness by both clinicians and patients.
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