W. A. Davis1, B. Smalls1, A. Haider1, M. Morris1 1Brigham And Women’s Hospital,Center For Surgery And Public Health, Department Of Surgery,Boston, MA, USA
Introduction:
Communication disabilities, including hearing, speech, language, and voice problems, are a barrier to effective communication in the healthcare setting. The extent of communication disabilities in the surgical population has never been described. We aimed to describe the prevalence of communication disabilities in adult surgical patients from a nationally representative sample.
Methods:
We conducted a cross-sectional analysis using the 2012 National Health Interview Survey (NHIS). NHIS is a nationally representative, stratified, multistage survey that uses face-to-face interviews with non-institutionalized respondents to estimate health care utilization, access, and health-related behaviors for the U.S. population. In 2012, NHIS included a one-time supplemental section focused on communication disabilities. We utilized the 2012 NHIS Sample Adult Core questionnaire to examine the frequency of hearing, speech, language, and voice disabilities in a subpopulation of adult NHIS respondents who reported an inpatient or outpatient surgical procedure within the last twelve months. Additional surgical details were not available. We then conducted subgroup analyses by age, gender, race, ethnicity, and geographic region. To generalize observed results to the U.S. population, survey weights and variance estimations were applied to all statistics.
Results:
In 2012, 12.2% (95% CI: 11.7-12.7%) of the US adult population reported a surgical procedure within the last year, and 22.9% (95% CI: 22.3-23.5) experienced a communication disability. Subpopulation analysis limited to surgical patients (Table 1) revealed that approximately one third (33.8%, 95% CI: 32.1-35.5) reported a communication disability. The most commonly reported disability was hearing (23.5, 95% CI: 21.8-25.2) followed by voice (12.8, 95% CI: 11.6-14.0), speech (4.6, 95% CI: 3.7-5.5), and language (2.2, 95% CI: 1.7-2.8).
Conclusion:
Patients with communication disabilities comprise a major segment of the U.S. adult surgical population. This high prevalence, when combined with a lack of medical professional training and awareness, not only calls into question surgeons’ ability to provide patient-centered care to a significant percentage of their patient population, but also suggests an opportunity to address a source of preventable adverse events, inadequate informed consent, and poor patient satisfaction.
