Prevalence of Professional Interpreter Use in Emergency Departments: A Systematic Review and Meta-Analysis.

Abstract

Background: Emergency departments (EDs) increasingly serve linguistically diverse populations. Professional interpretation improves care, yet its use remains variable. Quantifying the prevalence of use and understanding disparities can inform policies and interventions. We conducted a systematic review and meta-analysis to estimate the prevalence of professional interpreter use in English-speaking EDs and compare use across patient populations and countries.

Methods: Eight databases were searched from inception to May 15, 2025. We screened full texts included in a prior scoping review to identify studies reporting the prevalence of professional interpreter use among patients requiring interpretation in English-speaking EDs. We pooled prevalence overall and stratified by population (adult vs. children) and country (United States vs. other), with 95% prediction intervals and confidence intervals (CIs). Meta-regression assessed associations between study year and prevalence. Risk of bias was evaluated using the JBI checklist for prevalence studies.

Results: Thirty-two studies spanning 1997-2025 involving 65,736 participants were included. Professional interpreters were used in 29% (CI, 20%, 38%) of encounters with patients requiring interpretation. Use was higher with children (49%; CI, 41%, 58%) than adults (16%; CI, 11%, 22%), and higher in the United States (33%; CI, 24%, 43%) than other countries (14%; CI, 4%, 30%). There was no significant association between study year and interpreter use (p = 0.38).

Conclusions: Despite known benefits, professional interpreter use in EDs remains low, particularly among adults and outside the United States. Addressing this gap will require coordinated efforts from clinicians, health system leaders, and policymakers to improve access to and accountability for language-concordant care in EDs.