Abstract
To investigate barriers to healthcare access and utilization among patients with noninfectious uveitis (NIU) across different racial and ethnic groups. Retrospective cross-sectional study. Participants diagnosed with chronic NIU in the nationwide All of Us Research Program. 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. Financial and non-financial disparities in healthcare access among racial and ethnic groups. 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). 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.
Published Version
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