McKee Michael M, Winters Paul C, Sen Ananda, Zazove Philip, Fiscella Kevin
Department of Family Medicine, University of Michigan, USA.
Family Medicine Research Programs, Department of Family Medicine, School of Medicine and Dentistry, University of Rochester, USA.
Disabil Health J. 2015 Oct;8(4):573-8. doi: 10.1016/j.dhjo.2015.05.004. Epub 2015 May 29.
Deaf American Sign Language (ASL) users comprise a linguistic minority population with poor health care access due to communication barriers and low health literacy. Potentially, these health care barriers could increase Emergency Department (ED) use.
To compare ED use between deaf and non-deaf patients.
A retrospective cohort from medical records. The sample was derived from 400 randomly selected charts (200 deaf ASL users and 200 hearing English speakers) from an outpatient primary care health center with a high volume of deaf patients. Abstracted data included patient demographics, insurance, health behavior, and ED use in the past 36 months.
Deaf patients were more likely to be never smokers and be insured through Medicaid. In an adjusted analysis, deaf individuals were significantly more likely to use the ED (odds ratio [OR], 1.97; 95% confidence interval [CI], 1.11-3.51) over the prior 36 months.
Deaf American Sign Language users appear to be at greater odds for elevated ED utilization when compared to the general hearing population. Efforts to further understand the drivers for increased ED utilization among deaf ASL users are much needed.
美国使用手语的聋人群体属于语言少数群体，由于沟通障碍和健康素养较低，他们获得医疗保健的机会有限。这些医疗保健障碍可能会增加急诊科（ED）的就诊率。
比较聋人和非聋人患者的急诊科就诊情况。
对病历进行回顾性队列研究。样本来自一家有大量聋人患者的门诊初级保健健康中心随机抽取的400份病历（200名使用美国手语的聋人患者和200名讲英语的听力正常者）。提取的数据包括患者人口统计学信息、保险情况、健康行为以及过去36个月内的急诊科就诊情况。
聋人患者更有可能从不吸烟，且通过医疗补助计划参保。在一项校正分析中，聋人在过去36个月内使用急诊科的可能性显著更高（优势比[OR]为1.97；95%置信区间[CI]为1.11 - 3.51）。
与普通听力正常人群相比，使用美国手语的聋人患者急诊科利用率升高的可能性似乎更大。非常需要进一步了解聋人美国手语使用者急诊科利用率增加的驱动因素。
