The city’s comptroller accused New York City hospitals yesterday of denying immigrants access to critical services.

In a study of 51 public and private hospitals in the five boroughs, the comptroller, William Thompson Jr., said his office found that three-fourths of those institutions failed to communicate adequately with Spanish-speaking callers who were interested in becoming a patient, attempting to make an appointment, or inquiring with the billing office.

“While the face of New York is changing every day, our hospitals remain in an English-only time warp,” Mr. Thompson said, speaking at a press conference at the New York Immigration Coalition. “It is unconscionable that basic health care services remain out of reach for citizens who don’t speak English.”

Citing that the study found more than 40% of calls to hospitals ended in frustration, Mr. Thompson said men and women with little or no English proficiency are often discouraged when seeking help from the city’s hospitals.

“It’s costly for the entire health care system because poor communication deters people from getting timely treatment,” Mr. Thompson said. “Poor communication also results in increased costs and inefficiency overall.”

The study found that public hospitals performed better than the voluntary hospitals, and that, overall, emergency departments were more likely to provide satisfactory Spanish-access services.

A spokesman for the Greater New York Hospital Association, Brian Conway, responded in a statement that the cultural and linguistic diversity of New York, with residents from more than 200 countries, creates significant challenges for hospitals.

“Hospitals have emphasized the availability of interpreters for patients who present in person in inpatient, outpatient, and emergency room settings,” Mr. Conway wrote, noting that the importance of call-in services may have been overlooked. “The Comptroller’s report demonstrates that hospitals need to do better, and the hospital community is committed to improving in this area.”

Legislation introduced to set New York standards for hospital communication with patients is stalled in the state Senate.

Providing barriers to services is a violation of civil rights legislation, according to the president and general counsel of the Puerto Rican Legal Defense and Education Fund, Cesar Perales. He said that hospitals should not discriminate against people who don’t speak English well, and he warned that his organization would be investigating legal action if the situation does not improve.

Martha Pina, a 25-year-old immigrant from Mexico, said she had been taking English classes but could not understand when the doctor at a Queens hospital provided instructions on how to treat her 5-year-old son’s asthma. Breaking down in tears at the press conference, Ms. Pina said in Spanish: “I didn’t know how to give him the medicine. I was afraid to give him a worse reaction.”

Since the study was done on hospitals serving significant Spanish-speaking populations – Spanish is by far the most commonly spoken language after English – the findings indicate even greater challenges to people who rely on one of the more than 140 other languages spoken in New York.

“This is a problem that the city’s hospitals, particularly the city’s private hospitals, can no longer ignore,” the executive director of the New York Immigration Coalition, Margie McHugh, said. “How can Spanish speakers hope to get medical care when the hospital hangs up on them, insults them, or leaves them on hold forever?”

The comptroller offered several recommendations, including that the state Department of Health amend its patients’ rights regulations to require explicitly that hospitals provide language access services, designate an individual or a department to coordinate translation services, and promote language line translation services that are used by 911. Mr. Thompson also urged the Department of Health and Mental Hygiene to publicly monitor services in the same way it does food-service providers.