Language, Equity, And Quality Of Care: A Qualitative–Organizational Analysis Of Communication, Interpretation, And Trust In Contemporary Healthcare
Keywords:
Language access, limited English proficiency, quality of careAbstract
Language is a foundational yet persistently under-theorized dimension of healthcare quality and equity. Despite extensive policy frameworks mandating language access and a growing evidence base demonstrating the clinical importance of effective communication, patients with limited English proficiency continue to experience systematic disparities across access, processes of care, and outcomes. This article develops an integrated, qualitative–organizational analysis of language, interpretation, and quality of care by synthesizing insights from health services research, organizational behavior, qualitative methodology, and clinical ethics. Drawing strictly on the provided literature, the study advances a conceptual argument that language operates simultaneously as a structural condition, an interactional process, and an organizational resource within healthcare systems. Using qualitative methodological traditions grounded in naturalistic inquiry and grounded theory, the article reconstructs how clinicians, patients, and institutions negotiate language barriers in everyday practice, particularly in high-stakes contexts such as inpatient care, medication management, preventive services, and end-of-life decision-making. The analysis reveals that interpreter use is shaped not only by availability or policy compliance, but also by temporal pressures, professional norms, relational continuity, perceptions of efficiency, and moral judgments about care. Emerging technologies, including artificial intelligence–enabled language tools, are examined as both promising and problematic interventions that may reconfigure existing inequities if not implemented with attention to organizational context and power dynamics. By reframing language access as a core dimension of quality rather than an ancillary service, the article contributes a theoretically rich foundation for rethinking equity-oriented healthcare reform. The discussion articulates implications for clinical practice, organizational leadership, and future qualitative research, emphasizing the need for integrative approaches that align communication, trust, time, and justice within complex health systems.
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