Breaking Barriers: Exploring Patient Satisfaction With the U.S. Healthcare System Among Iranian and Afghan Immigrants With Limited English Proficiency

Objective: To explore the satisfaction of limited English proficiency (LEP) Farsi- and Dari-speaking patients with the U.S. healthcare system using a qualitative approach. Study Setting and Design: We employed a grounded theory approach to analyze qualitative data collected from five focus groups involving 25 Farsi- and Dari-speaking immigrants with LEP. Data Source and Analytical Sample: A total of 25 individuals with LEP participated in the focus group sessions, which were transcribed and analyzed using grounded theory methodology. Principal Findings: Two primary categories influencing satisfaction with care emerged: systemic factors and individual factors. Individual factors encompassed cultural beliefs, cross-contextual comparisons, experiences of misdiagnosis, and language barriers. Systemic factors, including discrimination, the high cost of care, the complexity of the U.S. healthcare system, and a pharmaco-centric approach to care, were found to negatively impact satisfaction among immigrants with LEP. Conclusions: Although many Farsi- and Dari-speaking individuals with LEP expressed satisfaction with the structured aspects of the U.S. healthcare system, dissatisfaction with healthcare providers and interpersonal interactions persisted. Addressing these issues will require targeted interventions to enhance trust, communication, and cultural competency in healthcare delivery.