Some 80% of U.S. hospitals frequently provide language services to patients who don't speak English well, but only 3% get any reimbursement for these services. A nationwide survey identified more than 15 languages that were frequently encountered by at least 20% of the 861 hospitals responding to the survey.

Ninety-three percent of facilities frequently encounter Spanish-speaking patients, making Spanish the most prevalent non-English language. Other prevalent languages included Chinese, Vietnamese, Russian, Arabic, Laotian, and Hindi.

Traditionally associated with cities, language barriers were just as significant in nonurban settings. States that have seen 100% growth in patients with limited English proficiency include Arkansas, Kansas, Kentucky, South Carolina, and Tennessee.

One barrier to providing adequate communication services is that hospitals, by law, are required to offer language services, but they aren't permitted to seek reimbursement for them. So facilities do the best they can with the resources they have. For example, some are educating bilingual employees, such as housekeeping staff, to provide medical interpretation.

The study was conducted by researchers from the Health Research and Educational Trust (HRET) and the National Health Law Program. For more information, visit the HRET's Web site at http://www.hret.org.