title: Emergency Department utilization among Deaf American Sign Language users.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  To compare ED use between deaf and non-deaf patients.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Family Medicine, University of Michigan, USA. Electronic address: mmmckee@med.umich.edu.
authors.forename: Michael M
authors.initials: MM
authors.lastname: McKee
authors.affiliation: Family Medicine Research Programs, Department of Family Medicine, School of Medicine and Dentistry, University of Rochester, USA.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Winters
authors.affiliation: Department of Family Medicine, University of Michigan, USA.
authors.forename: Ananda
authors.initials: A
authors.lastname: Sen
authors.affiliation: Department of Family Medicine, University of Michigan, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Zazove
authors.affiliation: Family Medicine Research Programs, Department of Family Medicine, School of Medicine and Dentistry, University of Rochester, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Fiscella
mesh_terms: D000293:Adolescent; D000328:Adult; D003144:Communication Barriers; D032882:Comprehension; D003638:Deafness; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006309:Hearing; D006801:Humans; D007802:Language; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D019986:Persons with Hearing Disabilities; D011320:Primary Health Care; D012189:Retrospective Studies; D012813:Sign Language; D012907:Smoking; D014481:United States; D055815:Young Adult
keywords: Deaf; Disabilities; Emergency Department utilization; Health access; LEP populations