Japan’s Hospitals Need More Professional Medical Interpreters

Japanese researchers Akira Oonishi, Ai Ikeda, Niyonsaba Francois, and Naoko Ono of Juntendo University and Astellas Pharma, Inc. published a paper on October 13, 2023, about their study of medical interpreting needs among foreign patients in Japan. The researchers conducted an online survey from February 2022 to May 2023.

The survey, which had a response rate of 7.3% (363 subjects out of 4,962 adult foreigners), collected responses from people who identified as non-native Japanese with varying degrees of fluency in the language. These foreigners had sought healthcare at medical facilities in Japan for their own illness or injuries, or had done so on behalf of their children. 

The study aimed to examine “the degree of patient comprehension of patient-provider communication, as well as patients’ need for professional medical interpreters in Japanese hospitals.” This topic has been previously addressed in other studies, and the researchers cited extensive references from around the world, explaining that “no previous studies have investigated patient comprehension of patient-provider communication and the necessity of medical interpreters on the basis of the degree of patient-provider discordance.”

“Language discordance” is defined in a related study as the situation when a patient’s primary spoken language differs from the primary language of the health system, the opposite of “concordance” in the same type of patient-provider interactions.

The survey was available in four languages (Chinese, English, “easy” Japanese, and Vietnamese). The questions addressed the experience of the adults themselves or their children at Japanese hospitals, and included other criteria such as language used in daily life, and demographic data like country of origin, age, length of residency in Japan, gender, illness perception scale, patient satisfaction, and “understanding of and interest in medical interpretation services and communication with physicians.”

The researchers mentioned that some of the groups of international patients who participated in the study did not use Japanese in their daily lives or use it on a very limited basis, and were less likely to understand their conversations and needed professional medical interpreters.

That need for professional medical interpreters was evaluated with the question “When using a Japanese hospital, would you like to use a medical interpreter service?,” with multiple choice answers: (a) I would like to use this service, (b) I would like to use this service in the language I use on a daily basis if it is available, (c) I would like to use this service if it is cheap (or free of charge), and (d) this service is unnecessary.

Underutilized

Through statistical analysis, the researchers established that the need for professional medical interpreters ranked higher among patients with low to no use of Japanese in their daily lives, and remarked that only seven of the 363 study participants (2.1%) had utilized professional medical interpreters.

“In actual clinical practice, medical interpreters are underutilized, even when patient-provider language discordance is recognized,” concluded the researchers. A data point offered as corroborating evidence in the paper originates in the Japanese Ministry of Health, Labor, and Welfare, and states that “the utilization rate of professional medical interpreters among 1,710 medical institutions across Japan was 12.7%.”

Citing findings in various previous studies with similar premises, the researchers made the recommendation for Japanese medical institutions to be prepared to provide professional medical interpreters for the specific populations of patients who do not use Japanese in everyday life, or who use it on a very limited basis.