Policy and Organizational Factors that Affect the Utilization of Health Services for Alzheimer's Disease Among the Latino Community - The Primary Care Provider Perspective.

Abstract

Background: Latino individuals bear a disproportionate burden of Alzheimer's disease and related dementias (ADRD), with higher risk, underdiagnosis, and limited access to quality care. Primary care providers (PCPs) are crucial for early detection and management. However, organizational and policy factors significantly impact their ability to provide culturally competent and equitable ADRD care for this community. This study explores PCP perspectives on these organizational and policy factors to inform the development of accessible models that improve early diagnosis, preventive care, and quality of life for Latino individuals with ADRD.

Methods: We used thematic analysis to analyze qualitative interviews with 23 diverse PCPs across the United States. We recruited our sample using snowball sampling. We strengthened the validity of our findings by using rigorous data reduction techniques.

Results: Key themes emerged, highlighting the interplay of organizational and policy factors: 1) Insurance eligibility and care options for those uninsured were foremost, with mandated language services facing access and quality challenges that affected the ability of clinicians to perform an accurate diagnosis. 2) Staffing and available resources dictated the type of care offered, leading to inconsistent protocols and options. Providers reported that workup was influenced by their level of training, time availability, and comfort. 3) While recognized as crucial, comprehensive assessments that include evaluation of their home and social environment were limited by appointment constraints and lack of follow-up resources.

Conclusion: Economic and organizational factors, including insurance, costs, staffing models, and resource navigation, shape PCPs' ability to deliver culturally competent and equitable ADRD care. Future interventions should address these barriers by training PCPs in dementia-related diagnostic procedures in Latino communities and developing accessible service models and culturally appropriate diagnostic tools.