Use of Routine Emergency Department Care Practices with Deaf American Sign Language Users

Background: Deaf individuals who communi-cate using American Sign Language (ASL) seem to experi-ence a range of disparities in health care, but there are few empirical data. Objective: To examine the provision of com-mon care practices in the emergency department (ED) to this population. Methods: ED visits in 2018 at a U.S. academic medical center were assessed retrospectively in Deaf adults who primarily use ASL (n = 257) and hearing individuals who primarily use English, selected at random (n = 429). Logistic regression analyses adjusted for confounders com-pared the groups on the provision or nonprovision of four routine ED care practices (i.e., laboratories ordered, med-ications ordered, images ordered, placement of peripheral intravenous line [PIV]) and on ED disposition (admitted to hospital or not admitted). Results: The ED encounters with Deaf ASL users were less likely to include labora-tory tests being ordered: adjusted odds ratio 0.68 and 95% confidence interval 0.47-0.97. ED encounters with Deaf in-dividuals were also less likely to include PIV placement, less likely to result in images being ordered in the ED care of ASL users of high acuity compared with English users of high acuity (but not low acuity), and less likely to result in hospital admission. Conclusion: Results suggest disparate provision of several types of routine ED care for adult Deaf ASL users. Limitations include the observational study design at a sin-gle site and reliance on the medical record, underscoring the need for further research and potential reasons for disparate ED care with Deaf individuals. (c) 2023 Elsevier Inc. All rights reserved.