Hidden cost of using interpreters: study

To be culturally safe, it is either a cost to the patient or a cost to the practice

General practices’ revenues are dented by the hidden cost of using professional interpreters in patient consultations, a study has found.

The study of an inner-city Wellington practice found it earns between $20 and $90 less per 15 minutes if a patient needs an interpreter.

The findings show capitation funding should recognise patients needing interpreters as high needs, because practices are bearing the cost, says specialist GP Samantha Murton, the GP lead of the study’s host, Capital Care Health Centre.

Dr Murton says using professional interpreters needs to be affordable for both patients and practices, as not using them is unsafe.

The study, by University of Otago medical student Andrew Xiao, found the hidden cost was due to the PHO-funded professional interpreter services requiring a double appointment of 30 minutes.

This meant the 92 patients needing interpreters, on average, had twice the number of 15-minute appointments than are covered by capitation funding (4.8 compared with the funded 2.4).

It was found that even charging patients a double fee for the 30-minute interpreter consultation did not cover the loss in capitation income. For example, the practice earned $90 less per 15-minute appointment with a woman Community Services Card holder aged over 65 if she needed an interpreter.

Dr Murton says practices are required to have a 30-minute appointment because using an interpreter is a “double conversation”. But charging patients a double fee doesn’t take into account the fact the practice isn’t getting capitation for the second half of the appointment. “To be culturally safe, it is either a cost to the patient or a cost to the practice [at present].”

The case study was supervised by Otago associate professor and specialist GP Ben Gray, who concluded last year in a Tū Ora Compass Health-funded position paper that funding of interpreter services in primary care is inequitable.