Barriers to Care in Hispanic American Patients with Diabetic Retinopathy

Diabetic retinopathy (DR) is a leading cause of vision loss in working-age adults. Hispanic patients, who experience higher rates of diabetes, may face barriers to timely ophthalmic care. This study aimed to identify barriers to DR care among Hispanic patients.

A cross-sectional survey was conducted at a single, resident-run retina clinic. Hispanic and non-Hispanic White patients with DR completed a verbally administered survey, assessing demographics, disease understanding, and financial challenges.

Eighty-four patients participated (60 Hispanic and 24 non-Hispanic White). Hispanic patients were more likely to have proliferative DR (76.6%, P = .001), live in higher-deprivation areas (P = .018), and rely on financial assistance (90%, P less than .001). Commonly reported barriers included transportation difficulties (40%), high surgical/inpatient fees (37%), outpatient visit costs (35%), lost income from time off work (35%), and challenges receiving medical calls during work hours (27% of employed patients). Compared to non-Hispanic White patients, Hispanic patients more frequently cited work responsibilities, food/lodging costs, and surgical fees, and were less likely to report chronic illness as a barrier (P = .038).

The research was conducted at a single, resident-run retina clinic, which may limit generalizability. Self-reported responses were also used and may be subject to recall bias.

Hispanic patients face multiple systemic and financial barriers to DR care, contributing to more severe disease at presentation. These findings highlight the importance of understanding the challenges that limit access to regular eye care, which may result in delayed diagnosis and more advanced stages of disease when patients first seek treatment.