Healthcare Access and Utilization: Understanding Racial Disparities in Primary Hyperparathyroidism

Previous studies have demonstrated racial disparities in healthcare access and utilization for patients with primary hyperparathyroidism (PHPT). To refine current interventions and enhance patient outcomes, it is important to understand the reason behind such disparities, which we aimed to identify in this study.

Patients diagnosed with PHPT who completed the Healthcare Access and Utilization Survey within the All of Us database were included. Data were collected on patient demographics and survey responses. A chi-square test and analysis of variance test compared differences between racial groups.

A total of 23.6% (n = 243) of patients delayed medical care, and 37.3% (n = 384) could not afford care. Paying out of pocket (10.3%) and nervousness (8.6%) were the most common reasons for delaying care. Prescription medications were the most common item patients could not afford (10.7%). Asian patients were more likely to delay care due to being unable to take time off work when compared to Black and White patients (23.5% versus 6.4% and 4.9%, P < 0.001). Black patients were less likely to afford the following compared to White and Asian patients: prescription medications (12.8% versus 9.3% versus 11.8%, P < 0.001), follow-up care (9.2% versus 3.4% versus 0%, P < 0.001), and specialist care (11.0% versus 4.1% versus 0%, P < 0.001). Asian and Black patients were more likely to find patient-physician concordance important when compared to White patients (82.4% versus 79.8% versus 69.9%, P < 0.001).

The racial background of PHPT patients within our cohort was associated with differences in reported reasons for delaying or being unable to afford care. Understanding the unique challenges faced by each racial group is crucial to creating targeted interventions that can improve healthcare access and utilization.