Evaluation of disparities in hospitalisation outcomes for deaf and hard of hearing patients with COVID-19: a multistate analysis of statewide inpatient databases from Florida, Maryland, New York and Washington

Abstract

Objective: Investigate whether deaf or hard of hearing (D/HH) patients with COVID-19 exhibited different hospitalisation outcomes compared with hearing patients with COVID-19.

Design: Cohort study SETTING: Statewide Inpatient Databases for Florida, Maryland, New York and Washington, for the year 2020.

Participants: Records of patients aged 18-64 years with COVID-19 PRIMARY OUTCOMES AND MEASURES: Differences in in-hospital death, 90-day readmission, length of stay, hospitalisation cost, hospitalisation cost per day, intensive care unit (ICU) or coronary care unit (CCU) utilisation and ventilation use were evaluated. Adjustment variables included patient basic characteristics, socioeconomic factors, and clinical factors.

Results: The analyses included 347 D/HH patients and 72 882 non-D/HH patients. Multivariable log-transformed linear regression models found an association of patients' hearing loss status with longer length of stay (adjusted mean ratio (aMR) 1.15, 95% CI 1.04 to 1.27, p<0.01), higher hospitalisation cost (aMR 0.96, 95% CI 1.00 to 1.22, p=0.049) and lower hospitalisation cost per day (aMR 0.96, 95% CI 0.92 to 1.00, p=0.04). We did not detect any significant relationships with other outcomes.

Conclusions: Our findings suggest that higher hospitalisation costs were attributed to prolonged stays rather than costly interventions, such as ICU care. Communication barriers between healthcare providers and D/HH patients, coupled with providers' cautious approach to discharging D/HH patients, may explain our findings.

Keywords: COVID-19; Disabled Persons; Hospitalization.