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基层医疗诊所中老年患者的听力筛查:环境及医护人员鼓励措施的效果如何因患者性别和种族而异。

Hearing Screening in Older Adults in Primary Care Clinics: How the Effects of Setting and Provider Encouragement Differ by Patient Sex and Race.

作者信息

West Jessica S, Dubno Judy R, Francis Howard W, Smith Sherri L

机构信息

Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA.

Center for Study of Aging and Human Development, Duke University School of Medicine, Durham, North Carolina, USA.

出版信息

Ear Hear. 2025;46(2):512-522. doi: 10.1097/AUD.0000000000001604. Epub 2025 Feb 17.

Abstract

OBJECTIVES

Few studies have examined how patient sex or race influence hearing healthcare, which was our study purpose.

DESIGN

We performed a secondary analysis using data from a pragmatic clinical trial that examined the effect of provider encouragement (yes/no) or setting (at-home/clinic) for older adults to follow through with routine hearing screening in primary care and the hearing healthcare pathway. Three protocols were compared: at-home screening without provider encouragement, at-home screening with provider encouragement, and in-clinic screening with provider encouragement.

RESULTS

Poisson regression (n = 627) showed few differences by patient sex but showed that Black patients in the at-home protocols were less likely to schedule or complete a formal diagnostic evaluation after a failed screening compared with Black patients in the clinic setting and White patients in all groups. Black patients, regardless of provider encouragement, were less likely to schedule or complete a diagnostic evaluation compared with White patients.

CONCLUSIONS

Results suggest that in-clinic screenings may increase the use of hearing healthcare for Black patients.

摘要

目的

很少有研究探讨患者性别或种族如何影响听力保健,这是我们的研究目的。

设计

我们使用一项实用临床试验的数据进行了二次分析,该试验研究了医疗服务提供者的鼓励(是/否)或地点(在家/诊所)对老年人在初级保健中进行常规听力筛查及听力保健途径的影响。比较了三种方案:无医疗服务提供者鼓励的在家筛查、有医疗服务提供者鼓励的在家筛查和有医疗服务提供者鼓励的诊所筛查。

结果

泊松回归分析(n = 627)显示,患者性别差异不大,但显示与诊所环境中的黑人患者以及所有组中的白人患者相比,在家筛查方案中的黑人患者在筛查失败后安排或完成正式诊断评估的可能性较小。与白人患者相比,无论医疗服务提供者是否给予鼓励,黑人患者安排或完成诊断评估的可能性都较小。

结论

结果表明,诊所筛查可能会增加黑人患者对听力保健的利用。

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