Impact of Primary Language and Insurance on Pediatric Hearing Health Care in a Multidisciplinary Clinic

被引:26
作者
Su, Brooke M. [1 ,2 ]
Park, Jason S. [3 ]
Chan, Dylan K. [3 ]
机构
[1] Univ Calif Los Angeles, Dept Head & Neck Surg, Los Angeles, CA USA
[2] Univ Calif San Francisco, Sch Med, San Francisco, CA USA
[3] Univ Calif San Francisco, Dept Otolaryngol Head & Neck Surg, 513 Parnassus Ave,Rm 719,UCSF Box 3213, San Francisco, CA 94143 USA
关键词
pediatric hearing loss; child; disparity; primary language; insurance; socioeconomic status; OF-LIFE QUESTIONNAIRE; COCHLEAR IMPLANTATION; UNITED-STATES; CHILDREN; RELIABILITY; DISPARITIES; ADOLESCENTS; POPULATION; VALIDITY; SPEECH;
D O I
10.1177/0194599817725695
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Objective This study aims to describe the effects of primary language and insurance status on care utilization among deaf or hard-of-hearing children under active otolaryngologic and audiologic care. Study Design Cross-sectional analysis. Setting Multidisciplinary hearing loss clinic at a tertiary center. Subjects and Methods Demographics, hearing loss data, and validated survey responses were collected from 206 patients aged 0 to 19 years. Two-sided t tests and (2) tests were used to obtain descriptive statistics and hypothesis testing. Results Of the sample, 52.4% spoke primarily English at home. Non-English-speaking children and families were less likely to receive psychiatric counseling (12.2% vs 35.2% in the English group, P < .001) and reported more difficulty obtaining educational interventions (P = .016), and 68.9% had public insurance. Parents of publicly insured children were less likely to know the type or degree of their child's hearing loss (56.9% vs 75.4%, P = .022), and these children were older on presentation to the clinic (8.5 vs 6.5 years of age, P = .01) compared to privately insured children. Publicly insured children were less likely to receive cochlear implants (P = .046) and reported increased difficulty obtaining hearing aids (P = .047). While all patients reported impairment in hearing-related quality of life, publicly insured children aged 2 to 7 years were more likely to perform below minimum thresholds on measures of auditory/oral functioning. Conclusion Even when under active care, deaf or hard-of-hearing children from families who do not speak English at home or with public insurance face more difficulty obtaining educational services, cochlear implants, and hearing aids. These findings represent significant disparities in access to necessary interventions.
引用
收藏
页码:722 / 730
页数:9
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