Barriers to Healthcare Access and Utilization Among Racial and Ethnic Minorities with Noninfectious Uveitis.

Abstract

Objective: To investigate barriers to healthcare access and utilization among patients with noninfectious uveitis (NIU) across different racial and ethnic groups.

Design: Retrospective cross-sectional study.

Subjects: Participants diagnosed with chronic NIU in the nationwide All of Us Research Program.

Methods: We analyzed healthcare access and utilization (HCA&U) and social determinants of health (SDoH) surveys. Racial and ethnic groups were defined as non-Hispanic White, non-Hispanic Black, Hispanic, and 'Other'. Multivariable logistic regression models adjusted for age, sex, education, insurance type, and income were used to assess disparities.

Main outcome measures: Financial and non-financial disparities in healthcare access among racial and ethnic groups.

Results: Of 2,452 NIU patients, 810 (33%) responded to the HCA&U survey and 607 (24.7%) to the SDoH survey. Non-Hispanic Black participants reported significantly more experiences of being treated with less courtesy (adjusted odds ratio 2.6, 95% confidence interval [1.4- 5], p=0.003) and respect (2.6 [1.4- 4.8], p=0.003), as well as receiving poorer services (3.6 [1.9- 6.9], p<0.001) compared to Non-Hispanic White participants. Individuals categorized as 'Other' minorities were more likely to delay seeking medical care due to out-of-pocket costs (3.4 [1.6- 7.1], p=0.001) and concerns over medical bills (2 [1.05- 3.8], p=0.04). Additionally, they experienced significant delays in care due to living in rural areas with limited access to healthcare providers (7.1 [1.4-35.6], p=0.02).

Conclusions: Racial and ethnic minorities with NIU face significant barriers to healthcare utilization and quality, underscoring the need for targeted interventions to address disparities and improve health equity in uveitis management.