Satisfaction with health care among people with hearing impairment: a survey of Medicare beneficiaries.

Purpose: The purpose of this study was to investigate the determinants of access to and satisfaction with health care from Medicare participants with hearing impairment.

Method: Raw data for the study was obtained from the 2004 Medicare Current Beneficiary Survey (MCBS). Satisfaction with care was assessed using 10 of the MCBS questions probing satisfaction in a number of areas related to health care. The data were analyzed using logistic regression. This analysis was conducted in three steps. The first step involved identifying potentially important predisposing and enabling variables that influenced satisfaction with care using univariate analysis. The second step involved fitting the variables retained from the first step into a multiple logistic regression equation to determine a preliminary main effects model. The final analysis included determining the odds ratio for each independent variable retained from the earlier analysis.

Results: Individuals with hearing impairment demonstrated some level of dissatisfaction with quality of health care. Each of the MCBS satisfaction questions were significantly (p < 0.05) associated with at least one of the communication variables.

Conclusions: Understanding the effects of hearing impairment on satisfaction with health care is critical to the delivery of effective and efficient services to individuals with such disabilities.

Implications For Rehabilitation: Presence of communication impairment, specifically hearing impairment, affects satisfaction with health care. Medical school training regarding methods to improve diagnosis and treatment of patients with communicative impairments could lead to improved patient-provider interactions and ultimately increased satisfaction with the provider and care given. Health care providers need to allow for extended appointments for patients with communication impairments. Time accommodations could prevent misunderstandings about diagnosis and treatment methods which otherwise might have detrimental results.