Patient-physician language concordance and long-term mortality: a retrospective cohort study of Canadians

Abstract

Linguistic diversity across North America is increasing rapidly. Prior studies have shown that patients who receive healthcare services in their preferred language have better short-term outcomes. We sought to determine whether patient-physician language concordance is associated with all-cause death in Canada. We performed a population-based, retrospective cohort study using data from the Canadian Community Health Survey (CCHS) from January 1, 2003 to December 31, 2014 linked to mortality records (until December 31, 2017). We determined respondents’ primary home language using language spoken most often at home (English, French, Indigenous language, or Allophone language [ie, other language]). We defined patient-physician language concordance as agreement between respondents’ primary home language and the language spoken with their regular medical doctor. We studied a total of 50,375 respondents. Very few Indigenous-language-speaking respondents (1.8%) received regular language-concordant physician care. Patient-physician language concordance was associated with a lower risk of all-cause death among both French-speaking respondents outside of Quebec (HR 0.89, 95% CI 0.79-1.00) and Allophone-language-speaking respondents (HR 0.73, 95% CI 0.65-0.83). Healthcare systems should prioritize the delivery of language-concordant physician care (eg, through patient-physician linguistic matching and/or use of evidence-based interpretation services), as this could potentially improve long-term survival in linguistically diverse populations.