Social determinants of health as barriers to care for vasculitis: perspectives of patients and healthcare providers.

Abstract

This study examined patient and healthcare provider (HCP) perspectives on the impact of unmet social needs on healthcare barriers for patients with vasculitis. Two surveys were developed to gather perspectives from patients with vasculitis, and HCPs specializing in vasculitis care. The patient survey also included a 20-question social needs assessment. The data were analyzed using descriptive statistics. One hundred patients and 31 HCPs completed the surveys between September 2022 and June 2023. Fifty-six percent of patients reported unmet social needs, with poor social and mental health (30%) being the most common. Sixty-three percent of patients with vasculitis perceived unmet social need(s) as barriers to healthcare access. Financial insecurity (30%), poor mental health (29%), and poor health knowledge (25%) were the most common barriers identified. Overall, HCPs perceived SDOH have a greater impact on healthcare access than the patients surveyed. Most patients (82%) and HCPs (90%) believed rheumatologists should help in the management of SDOH, specifically health knowledge and mental health. Few HCPs (10%) felt well-positioned to address patients' mental health. Suggested interventions that address social needs and improve healthcare access included referrals to community-based resources, providing educational materials, and virtual visits. Through patient and HCP perspectives, the impact of SDOH on healthcare access for patients with vasculitis was explored. Understanding the positive experiences and challenges faced by patients is crucial for developing targeted interventions to enhance healthcare access. These findings underscore the importance of ongoing efforts to improve the healthcare experience for patients with vasculitis. Key Points • The impact of unmet social needs on healthcare access for patients with vasculitis, illustrates the complex relationship between SDOH and healthcare outcomes. • Unmet social needs among patients with vasculitis, included poor social and mental health, financial and food insecurity, and a lack of health literacy, which may exacerbate challenges leading to poor health outcomes. • The differences in perspectives between patients and healthcare providers regarding the impact of certain SDOH on healthcare access, necessitates the importance of co-production in the development of interventions to improve healthcare delivery. • The importance of patient-centered care and tailored solutions was highlighted by the need for various interventions to address social needs and improve healthcare access, such as referrals to community-based resources, educational materials, and interprofessional collaboration.