Patients who are deaf have difficulty establishing primary, dental care

Patients who are deaf and request interpreter services may have difficulty establishing primary care and dental care, according to research published in JAMA Network Open.

“In this cross-sectional audit study of a statewide representative sample of primary medical care and general dentistry clinics, patients who are deaf experienced diminished access to care in both settings,” Elizabeth Schniedewind, EdD, clinical associate professor at Idaho State University, and colleagues wrote. “Their requests to establish care were unsuccessful more frequently compared with requests made by patients who can hear.”

In their study, Schniedewind and colleagues had simulated patients call a random sample of primary care and dental clinics in Idaho. Simulated patients followed a script in which they were adults trying to establish care and request a new patient visit.

A total of 229 primary care clinics and 100 dentistry clinics were included in the sample.

Eight simulated patients were involved in the study, half of whom were deaf and half of whom could hear. In addition to requesting new patient visits and providing basic information, simulated patients who were deaf also requested interpreter services for their appointment.

Simulated patients made 1,096 calls from June 7, 2019, through December 6, 2019.

Among the simulated patients who could hear, 64.4% of calls for new patient visits were successful. In comparison, simulated patients who were deaf successfully obtained new patient visits for 49.1% of calls.

According to the researchers, patients who were deaf were more likely to have successful calls for new appointments at dental clinics, with 63.5% of calls successful compared with 53.7% of calls to primary care clinics.

Schniedewind and colleagues determined that patients who could hear were more likely to successfully schedule an appointment than those who were deaf after adjusting for simulated patient sex and number of calls made (adjusted OR = 1.88; 95% CI, 1.27-2.79).

They also found that of the unsuccessful calls among patients who were deaf, 48.2% were associated with their request for an interpreter. Additionally, they determined that these interpreter-related denials were more likely to occur in calls to dental clinics than calls to primary care clinics.

“A request for interpreting services, even when required for effective communication, was the most common reason appointment requests by patients who are deaf were unsuccessful,” Schniedewind and colleagues wrote. “Training of clinic staff may result in improved access to health care for patients who are deaf.”