Assessing Deaf patients in the neurology clinic

“…14 Without interpreters, health care professionals who are not fluent in ASL may be unable to appreciate subtle presentations or symptoms of conditions that require communication for assessment. 15 The provision of interpreter services for patients who are deaf is associated with better adherence to preventive screening recommendations. 16 In one study, failure to provide requested interpreter services resulted in 82% of patients being unable to understand their diagnosis, 70% not understanding the guidelines for their treatment, and 63% choosing to discontinue care.…”

Section: Introductionmentioning

confidence: 99%

“…This lack of communication can result in misunderstanding of diagnoses and poor adherence to treatment regimens . Without interpreters, health care professionals who are not fluent in ASL may be unable to appreciate subtle presentations or symptoms of conditions that require communication for assessment …”

Section: Introductionmentioning

confidence: 99%

Comparison of Access to Primary Care Medical and Dental Appointments Between Simulated Patients Who Were Deaf and Patients Who Could Hear

2021

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IMPORTANCE Primary medical and dental clinics may accept fewer people who are deaf as patients than persons who can hear, and clinics may deny requests by patients who are deaf for American Sign Language (ASL) interpretation at appointments when necessary, creating diminished access to primary medical and dental care. OBJECTIVE To compare the rate at which patients who are deaf are offered primary care medical or dental appointments with the rate at which appointments are offered to patients who can hear in a real-world context. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study used a simulated patient (SP) call audit method. Simulated patients (4 who could hear and 4 who were deaf) followed a call script in which an adult sought to establish care, requesting new patient appointments from a statewide stratified random sample of clinicians listed in the Idaho Medical and Dental Associations member databases at 445 clinics (334 primary care and 111 general dentistry) throughout Idaho. Simulated patients who were deaf also requested interpreting services at the appointment. Calls were made between June 7 and December 6, 2018. Data analysis was conducted from December 2019 to April 2020. EXPOSURES Simulated patients who were deaf or could hear called primary care medical or dental clinics from the sampling frame and requested an appointment, supplying the same basic information. In addition, SPs who were deaf requested that an ASL interpreter be provided by the clinic for the appointment. MAIN OUTCOMES AND MEASURESRates of new appointments offered and, for SPs who were deaf, whether ASL interpreter services were confirmed for the appointment.RESULTS Two male and 2 female SPs who could hear were successful on 210 occasions (64.4%) when requesting a new patient appointment compared with 2 male and 2 female SPs who were deaf who were successful on 161 occasions (49.1%) (P < .001). Simulated patients who could hear were nearly 2 times more likely to secure appointments than were SPs who were deaf (adjusted odds ratio, 1.88; 95% CI, 1.27-2.79). For SPs who were deaf, 80 unsuccessful appointment requests (48.2%) were associated with a request for interpretation. CONCLUSIONS AND RELEVANCEThe findings suggest that in a statewide representative sample, access to primary medical and dental care for patients who are deaf is significantly reduced. Patients who are deaf may not receive an appointment if they request interpreter services, even when such services are required to provide effective communication.

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