Barriers to Accessing Urogynecologic Care: A Single-Site Survey Study

Area of Science:

• Urogynecology
• Health Services Research
• Health Equity

Background:

• Disparities in urogynecologic care are recognized, yet patient-identified obstacles are not well understood.
• Understanding these barriers is crucial for developing equitable healthcare strategies.

Purpose of the Study:

• To investigate how structural and informational barriers to urogynecologic care differ based on race and neighborhood socioeconomic status.
• To utilize the Area Deprivation Index (ADI) as a measure of neighborhood disadvantage.

Main Methods:

• A cross-sectional study surveyed 219 new urogynecology patients using a 23-item questionnaire.
• Data included patient-reported barriers, demographics, and clinical information.
• Neighborhood socioeconomic disadvantage was assessed using zip code-linked Area Deprivation Index (ADI) percentiles.

Main Results:

• Black patients, on average, lived in neighborhoods with higher disadvantage (ADI 80.0) compared to White patients (ADI 53.4).
• Increased ADI correlated with longer travel times and seeing multiple providers before referral.
• Black race was linked to reporting more barriers and taking time off work as a barrier.

Conclusions:

• Race and neighborhood disadvantage are independently associated with specific barriers to urogynecologic care.
• Findings support the need for targeted, equity-focused interventions to address these disparities.
• Healthcare institutions should evaluate community-specific barriers to improve patient access.