Tyler G James1, Michael M McKee2, M David Miller3, Meagan K Sullivan4, Kyle A Coady5, Julia R Varnes6, Thomas A Pearson7, Ali M Yurasek8, JeeWon Cheong9. 1. Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA; Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA. Electronic address: jamesty@med.umich.edu. 2. Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA. Electronic address: mmmckee@med.umich.edu. 3. School of Human Development and Organizational Studies in Education, University of Florida, Gainesville, FL, USA. Electronic address: dmiller@coe.ufl.edu. 4. Deaf Community Advisory Board Member, USA. Electronic address: Msully94@ufl.edu. 5. Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA. Electronic address: kcoady@ufl.edu. 6. Department of Health Services Research, Management, and Policy, University of Florida, Gainesville, FL, USA. Electronic address: jrvarnes@ufl.edu. 7. Department of Epidemiology, University of Florida, Gainesville, FL, USA. Electronic address: tapearson@ufl.edu. 8. Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA. Electronic address: A.yurasek@ufl.edu. 9. Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA. Electronic address: jwcheong@ufl.edu.
Abstract
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 modalities. OBJECTIVE: 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, 1000 DHH English speakers, and 1000 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 a 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.
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 modalities. OBJECTIVE: 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, 1000 DHH English speakers, and 1000 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 a 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.
Authors: Meenakshi P Balakrishnan; Jill Boylston Herndon; Jingnan Zhang; Thomas Payton; Jonathan Shuster; Donna L Carden Journal: Acad Emerg Med Date: 2017-08-14 Impact factor: 3.451
Authors: Tyler G James; Kyle A Coady; Jeanne-Marie R Stacciarini; Michael M McKee; David G Phillips; David Maruca; JeeWon Cheong Journal: Qual Health Res Date: 2021-11-25
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Authors: Tyler G James; Julia R Varnes; Meagan K Sullivan; JeeWon Cheong; Thomas A Pearson; Ali M Yurasek; M David Miller; Michael M McKee Journal: Int J Environ Res Public Health Date: 2021-12-07 Impact factor: 3.390