Ask and ye shall not receive: Interpreter-related access barriers reported by Deaf users of American sign language

Background: Healthcare providers are mandated to provide reasonable accommodations for Deaf users of American Sign Language (ASL) accessing healthcare services, including ASL interpreters. Provision of accommodations improves access and provider/patient communication. Objective: Describe the types, frequency, severity, and trends in healthcare access complications experienced by Deaf patients. Methods: A six-year retrospective review of complaints (n = 108) filed regarding interpreter provision in healthcare settings with the Idaho Council for the Deaf and Hard of Hearing by Deaf users of ASL was conducted and summarized. An analysis of demographic and language factors associated with interpreter-related barriers and whether the complaint was resolved was performed using multivariate logistic regression. Results: Reasons for complaints of interpreter-related barriers to care included: 48.2% were told an interpreter was not available; 28.7% received an unqualified interpreter; interpreter was promised but not provided (18.5%). Factors independently associated with having been promised an interpreter were: medical clinics (vs. dental) (OR 3.92 95%CI 1.18-12.98), and complaints filed later in the study period (OR 1.55 per year 95%CI 1.19-2.01). For each additional year during the study period, complaints were 1.6 times (95%CI 1.15-2.22) more likely to have an interpreter promised but not provided. Patients from rural areas were less likely to have their complaints satisfactorily resolved (OR 0.18 95%CI 0.06-0.55). Conclusion: Deaf patients experience various interpreter-related barriers throughout the process of accessing healthcare and communicating with providers/staff, though further regional and nationwide documentation is warranted. (C) 2020 Elsevier Inc. All rights reserved.