Conceptual Model of Emergency Department Utilization among Deaf and Hard-of-Hearing Patients: A Critical Review

Tyler G. James, Julia R. Varnes, Meagan K. Sullivan, JeeWon Cheong, Thomas A. Pearson, Ali M. Yurasek, M. David Miller and Michael M. McKee
Additional contact information
Tyler G. James: Department of Family Medicine, School of Medicine, University of Michigan, 1018 Fuller St., Ann Arbor, MI 48104, USA
Julia R. Varnes: Department of Health Services Research, Management, and Policy, University of Florida, P.O. Box 100185, Gainesville, FL 32610, USA
Meagan K. Sullivan: Independent Researcher, Gainesville, FL 32601, USA
JeeWon Cheong: Department of Health Education and Behavior, University of Florida, Florida Gym Room 5, P.O. Box 118210, Gainesville, FL 32611, USA
Thomas A. Pearson: Department of Epidemiology, University of Florida, P.O. Box 100231, Gainesville, FL 32610, USA
Ali M. Yurasek: Department of Health Education and Behavior, University of Florida, Florida Gym Room 5, P.O. Box 118210, Gainesville, FL 32611, USA
M. David Miller: School of Human Development and Organizational Studies in Education, University of Florida, P.O. Box 117047, Gainesville, FL 32611, USA
Michael M. McKee: Department of Family Medicine, School of Medicine, University of Michigan, 1018 Fuller St., Ann Arbor, MI 48104, USA

IJERPH, 2021, vol. 18, issue 24, 1-26

Abstract: Deaf and hard-of-hearing (DHH) populations are understudied in health services research and underserved in healthcare systems. Existing data indicate that adult DHH patients are more likely to use the emergency department (ED) for less emergent conditions than non-DHH patients. However, the lack of research focused on this population’s ED utilization impedes the development of health promotion and quality improvement interventions to improve patient health and quality outcomes. The purpose of this study was to develop a conceptual model describing patient and non-patient (e.g., community, health system, provider) factors influencing ED utilization and ED care processes among DHH people. We conducted a critical review and used Andersen’s Behavioral Model of Health Services Use and the PRECEDE-PROCEED Model to classify factors based on their theoretical and/or empirically described role. The resulting Conceptual Model of Emergency Department Utilization Among Deaf and Hard-of-Hearing Patients provides predisposing, enabling, and reinforcing factors influencing DHH patient ED care seeking and ED care processes. The model highlights the abundance of DHH patient and non-DHH patient enabling factors. This model may be used in quality improvement interventions, health services research, or in organizational planning and policymaking to improve health outcomes for DHH patients.

Keywords: deaf; hard of hearing; hearing loss; critical review; emergency department; health behavior; conceptual model (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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