Access to Orthopedic Care for Deaf Patients With Distal Radius Fractures

This study aimed to determine whether deaf patients experience barriers to orthopedic care compared with hearing patients through evaluating time to appointment, appointment denial rates, and interpreter availability.

Researchers called 132 randomly selected US orthopedic offices to request appointments for fictitious patients with distal radius fractures. Each office was called twice on the same weekday over different weeks-once for a hearing patient and once for a deaf patient communicating in American Sign Language (ASL). The primary outcome was time to appointment. Secondary analysis included provider type, ASL interpreter availability, interpreter modality, and requests for family interpretation. Differences in time to appointment with P values were determined using Wilcoxon signed-rank, Mann-Whitney U, and Kruskal-Wallis tests.

Data from 132 clinics (63 academic and 69 community/private practices) were analyzed. The time to appointment for patients across all regions, practices, and providers was 3.9 days. Deaf patients experienced significantly longer wait times for physician appointments (4.96 vs 3.32 days, P value: .0031). When considering all providers (physicians, nurse practitioners, and physician associates), deaf patients did not wait significantly longer (4.43 vs 3.38 days, P value: .06). Most offices (81.8%) offered interpreters, with academic institutions more likely to guarantee ASL interpretation (95.5%) than community/private practices (68.2%). Some offices (17.9%) requested family members interpret instead.

Distal radius fractures are common, and evidence suggests prompt care results in better outcomes and quicker return-to-work time. This study demonstrates statistically but not necessarily clinically significant delays for deaf patients seeking surgical appointments with MDs and reliance on ad hoc interpreters.