Health Care Disparities Among English-Speaking and Spanish-Speaking Women With Pelvic Organ Prolapse at Public and Private Hospitals: What Are the Barriers?

Abstract

Objectives The objective of this study was to compare perceptions and barriers between Spanish-speaking and English-speaking women in public and private hospitals being treated for pelvic organ prolapse (POP). Methods Eight focus groups, 4 in English and 4 in Spanish, were conducted at 3 institutions with care in female pelvic medicine and reconstructive surgery. Standardized questions were asked regarding patients' emotions to when they initially noticed the POP, if they sought family support, and their response to the diagnosis and treatment. Transcripts were analyzed using grounded theory qualitative methods. Results Thirty-three women were Spanish-speaking and 25 were English-speaking. Spanish speakers were younger (P = 0.0469) and less likely to have a high school diploma (P < 0.0001) than English speakers. Spanish-speaking women had more concerns that the bulge or treatments could lead to cancer, were more resistant to treatment options, and were less likely to be offered surgery. Women in the private hospital desired more information, were less embarrassed, and were more likely to be offered surgery as first-line treatment. The concept emerged that patient care for POP varied based on socioeconomic status and language and suggested the presence of disparities in care for underserved women with POP. Conclusions The discrepancies in care for Spanish-speaking women and women being treated at public hospitals suggest that there are disparities in care for POP treatment for underserved women. These differences may be secondary to profit-driven pressures from private hospitals or language barriers, low socioeconomic status, low health literacy, and barriers to health care.

Attendance at Prescribed Pelvic Floor Physical Therapy in a Diverse, Urban Urogynecology Population

“…Through focus groups, Spanish‐speaking women with POP were more often offered conservative therapies as opposed to English‐speakers, who were more often offered surgical management as first‐line treatment. Spanish‐speakers preferred speaking with their physician directly in Spanish over an interpreter and desired more educational aids [22]. Therefore, in addition to the factors that influence attendance, Spanish‐speakers may face additional challenges that influence PFPT attendance.…”

A systematic review and meta‐synthesis of qualitative studies on pelvic organ prolapse for the development of core outcome sets

“…Women seem to have variable priorities based on cultural aspects, society's norms and other population factors varying by countries and geographical regions. Pelvic floor disorders and their impact on women are addressed in different ways and women's awareness of this condition is widely variable 3–6 . While some women may not seek medical care or wait for several years before seeking medical care for POP, 7,8 some women only disclose relevant information when asked questions directly about their symptoms and their impact on the quality of life, which also appears highly variable 9–13 .…”

“…Pelvic floor disorders and their impact on women are addressed in different ways and women's awareness of this condition is widely variable. [3][4][5][6] While some women may not seek medical care or wait for several years before seeking medical care for POP, 7,8 some women only disclose relevant information when asked questions directly about their symptoms and their impact on the quality of life, which also appears highly variable. [9][10][11][12][13] The impact on individual patients but also on clinical practice and research is therefore highly variable.…”

Access to Norwegian healthcare system – challenges for sub-Saharan African immigrants

“…However, the extent of use of health services among immigrants may vary depending on their health care needs, health care seeking behaviors, the organization of health care in their home country, practical barriers to access in the host country, health literacy, migrant's status, education level and other socioeconomic factors [15,[18][19][20][21][22][23][24][25]. Examining issues of accessibility to healthcare among immigrants including understanding their experiences in accessing health care, is essential to improving their health.…”