Journal names study by ETSU’s Dr. Martin one of top publications

Contact: Brad Lifford
October 15, 2010

JOHNSON CITY – A health care journal has presented an award of excellence to an East Tennessee State University assistant professor of public health for a study of variables that affect the delivery of quality primary health care.

Dr. Brian Martin, an assistant professor in the ETSU College of Public Health’s Department of Health Services Administration, was one of only three winners chosen to receive a Highly Commended Award at the Literati Network Awards for Excellence 2010. Martin and his co-authors, Dr. Leiyu Shi of Johns Hopkins University and Ryan Ward, a former graduate assistant in ETSU’s Department of Health Services Administration, received the award for their study of how the race and gender of patients, as well as the language they speak, affect their assessment of the quality of primary care they receive.

Their study was published in the International Journal of Health Care Quality Assurance, and some of their findings are unique. Martin said that he and his colleagues found that language barrier – but not necessarily gender or race – may be a key predictor.

“Our study didn’t reach the same conclusions as those from some previous studies, because we didn’t find that race and gender were significant factors in determining health care quality,” Martin said. “What we did find is that a language barrier, a patient’s ability to communicate with his or her primary care physician, does play a significant role.”

Martin cautioned that there needs to be additional study of the relationship of race and gender as they relate to quality of care, as it is well-documented that minority populations experience disproportionate health disparities, and that several variables can contribute to health disparities. He said that should further study confirm their findings on the relation of language to health care quality, it could have serious policy implications for providers, as the percentage of patients who do not speak English continues to grow.

“Being able to communicate with your provider really is a basic quality issue,” Martin said. “Is a patient able to understand and answer a physician’s questions, or is the patient able to ask questions about treatment options? Can the patient reach the provider after hours? All of those are scenarios where we found that language could be a significant barrier.”

The providers who would be most affected, Martin said, are primary care physicians in smaller practices. Martin, who is the coordinator of the Master of Public Health degree program and health care management certificate program in the College of Public Health, has conducted previous research on cost of health care and access to it.

“Hospitals, health systems, and health departments do a good job with language issues because they have the resources,” Martin said. “But it could be a challenge for a primary care provider. You would have to ask yourself, ‘Do I have someone on staff who can act as an interpreter?’ It can be an issue, especially for smaller practices. When providers are in a community where demographic changes occur and you have more Spanish-speaking residents in your community, the number of Spanish-speaking patients seen may increase, but you also have the opportunity to draw from a larger bilingual community in your hiring practices.”