Objectives: We evaluated the health care utilization of limited English proficiency (LEP) compared to English proficient (EP) adults with the same health insurance (Medicaid managed care) and full access to professional medical interpreters. Methods: Health care utilization over two years was compared for 567 LEP and 1162 EP adults. Multivariate analysis controlled for age, gender, months enrolled in Medicaid and morbidity. Results: LEP compared to EP subjects were enrolled longer and more continuously in Medicaid, were 94% more likely to use primary care and 78% less likely to use the emergency department. Specialty visits and hospitalization did not differ. Conclusions: When language barriers are reduced and health insurance coverage is the same, LEP patients show ambulatory health care utilization associated with lower cost and more access to preventive care through establishing a primary care home. © Springer Science+Business Media, LLC 2007.

Immigrant Managed care Interpreter Ambulatory care Medicaid Refugee Limited English proficiency

Communication Barriers managed care hospitalization primary medical care lowest income group poverty interpersonal communication health insurance human middle aged controlled study priority journal morbidity emergency ward language United States health care cost Humans Managed Care Programs male female Multivariate Analysis health services Article health care utilization interpreter service adult gender age ambulatory care medicaid Emergency Service, Hospital primary health care Specialties, Medical