Background. Deaf and hard-of-hearing (DHH) patients are an underserved priority population. Existing, although contextually limited, findings indicate that DHH patients are more likely to use the emergency department (ED) than non-DHH patients. However, little attention has been given to the differences in ED utilization by patients’ language modality. Objective/Hypothesis: We hypothesized that DHH ASL-users and DHH English-speakers would have higher rates of ED utilization in the past 36 months, than non-DHH English-speakers. Methods. We used a retrospective chart review design using data from a large academic medical center in the southeastern United States. In total, 277 DHH ASL-users, 1,000 DHH English-speakers, and 1,000 non-DHH English-speakers were included. We used logistic regression and zero-inflated modeling to assess relations between patient segment and ED utilization in the past 12- and 36-months. We describe primary ED visit diagnosis codes using AHRQ Clinical Classifications Software. Results. DHH ASL-users and DHH English-speakers had higher adjusted odds ratios of using the ED in the past 36-months than non-DHH English-speakers (aORs = 1.790 and 1.644, respectively). Both DHH ASL-users and DHH English-speakers had higher frequency of ED visits, among patients who used the ED in the past 36-months (61.0% and 70.1%, respectively). The most common principal diagnosis code was for abdominal pain, with DHH English-speakers making up over half of all abdominal pain encounters. Conclusions. DHH ASL-users and DHH English-speakers are at higher risk of using the ED compared to non-DHH English-speakers. We call for additional attention on DHH patients in health services and ED utilization research.
Is this paper peer reviewed? This paper is published in Disability and Health Journal. This journal uses double-blind peer review, where the authors and the reviewers do not know each other’s identities.
Who paid for this project? This project was supported by grant number R36HS027537 from the U.S. Agency for Healthcare Research and Quality (PI: T.G.J.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.
Are there any conflicts of interest? There are no conflicts of interest.