Dataset Information

Emergency department utilization among deaf and hard-of-hearing patients: A retrospective chart review.

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.

SUBMITTER: James TG

PROVIDER: S-EPMC9320896 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Publications

Emergency department utilization among deaf and hard-of-hearing patients: A retrospective chart review.

James Tyler G TG McKee Michael M MM Miller M David MD Sullivan Meagan K MK Coady Kyle A KA Varnes Julia R JR Pearson Thomas A TA Yurasek Ali M AM Cheong JeeWon J

Disability and health journal 20220420 3

<h4>Background</h4>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.<h4>Objective</h4>We hypothesized that DHH ASL-users and DHH English speakers would have higher rates of ED utilization in the past 36 mo ...[more]

PMID: 35581134

Similar Datasets

Project description:BackgroundDeaf and hard-of-hearing (DHH) patients are a priority population for emergency medicine health services research. DHH patients are at higher risk than non-DHH patients of using the emergency department (ED), have longer lengths of stay in the ED and report poor patient-provider communication. This qualitative study aimed to describe ED care-seeking and patient-centred care perspectives among DHH patients.MethodsThis qualitative study is the second phase of a mixed-methods study. The goal of this study was to further explain quantitative findings related to ED outcomes among DHH and non-DHH patients. We conducted semistructured interviews with 4 DHH American Sign Language (ASL)-users and 6 DHH English speakers from North Central Florida. Interviews were transcribed and analysed using a descriptive qualitative approach.ResultsTwo themes were developed: (1) DHH patients engage in a complex decision-making process to determine ED utilization and (2) patient-centred ED care differs between DHH ASL-users and DHH English speakers. The first theme describes the social-behavioural processes through which DHH patients assess their need to use the ED. The second theme focuses on the social environment within the ED: patients feeling stereotyped, involvement in the care process, pain communication, receipt of accommodations and discharge processes.ConclusionsThis study underscores the importance of better understanding, and intervening in, DHH patient ED care-seeking and care delivery to improve patient outcomes. Like other studies, this study also finds that DHH patients are not a monolithic group and language status is an equity-relevant indicator. We also discuss recommendations for emergency medicine.Patient or public contributionThis study convened a community advisory group made up of four DHH people to assist in developing research questions, data collection tools and validation of the analysis and interpretation of data. Community advisory group members who were interested in co-authorship are listed in the byline, with others in the acknowledgements. In addition, several academic-based co-authors are also deaf or hard of hearing.

Project description:Rationale & objectiveTo evaluate predictors of emergency department (ED) utilization by adult patients receiving hemodialysis (HD) and interventions to reduce ED utilization by HD patients.Study designWe searched Ovid MEDLINE, Ovid Embase, and the Cochrane Library for randomized controlled trials and observational studies published until April 2020.Setting & participantsWe included studies that investigated predictors of ED utilization and/or interventions to reduce ED utilization in HD patients. We extracted data regarding the study design and study population and results regarding ED utilization from 38 studies using Excel software.Analytical approachWe performed a narrative synthesis to group articles that investigated similar themes.Results1,060 titles and abstracts were screened, of which 98 were selected for full-text review. In total, 38 studies met the inclusion criteria and underwent data extraction. Quality was high according to the Downs and Black tool, with 11 studies rated as good, 22 as fair, and 5 as poor. 34 studies described predictors of ED utilization, whereas 4 studies investigated interventions in which ED utilization was studied. Our narrative synthesis produced 8 concept subgroups in the core concepts of access to care, comorbid condition burden, and new health care models. Poor access to care and a high comorbid condition burden are associated with increased ED use. No ED-based interventions designed to reduce ED utilization were identified, but recent changes in health care systems, like the formation of End-Stage Renal Disease Seamless Care Organizations and greater involvement of palliative care services, are associated with improved outcomes.LimitationsClinical heterogeneity and variability in the included studies precluded a meta-analysis.ConclusionsHD patients' high ED use is multifactorial. Further research is required to understand and predict ED utilization in this vulnerable population, which will facilitate the development of interventions to reduce avoidable ED use.Prospero registration numberCRD42020196569.

Dataset Information

Emergency department utilization among deaf and hard-of-hearing patients: A retrospective chart review.

Background

Objective

Methods

Results

Conclusions

Publications

Emergency department utilization among deaf and hard-of-hearing patients: A retrospective chart review.

Similar Datasets

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