Disparities in Healthcare Services Efficiency and Patient-Provider Communication Quality Among Deaf and Hard-of-Hearing Patients in the U.S.: A Multi-Year Cross-Sectional Analysis (2017-2020).

The marginalization of the Deaf and Hard of Hearing (D/HH) group arises from barriers at multiple levels of the socio-ecological matrix. This is primarily reflected in challenges related to effective healthcare services delivery and high-quality patient-provider communication. Utilizing national data from the Health Information National Trends Survey (HINTS) from 2017 to 2020, we examined the difference between D/HH adults and hearing-abled adults in terms of healthcare services efficiency, patient-provider communication quality, health self-efficacy, and psychological health. The findings revealed that D/HH adults consistently exhibited lower levels than hearing adults in healthcare services efficiency, health self-efficacy, and psychological health, and these differences remained evident from 2017 to 2020. However, the difference in patient-provider communication quality between the two groups was not significant. The study further investigates health self-efficacy as a potential mediator influencing the efficiency of healthcare services and quality of patient-provider communication in their relationship with psychological health. Our findings highlight the imperative to devise specialized communication strategies and enhance healthcare services for the D/HH group.