Barriers to Access to Care in Hispanics With Type 2 Diabetes: A Systematic Review

Abstract

Introduction: Type 2 diabetes (T2D) is a major cause of death in the United States. Hispanics living in America suffer disproportionally with diabetes and is the fifth cause of death for them. A systematic review was conducted that highlighted barriers to access to care for Hispanics with T2D during the early years of the Affordable Care Act. Method: PubMed and CINAHL databases were searched (2010-2015) using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. From 84 studies, seven qualitative/mixed methods studies were reviewed based on inclusion/exclusion criteria. Barriers were placed into three categories set a priori. Results: All study samples were from different states, representing barriers across the United States. Persistent barriers were self (100%), provider (100%), and environment (71%). Covariates (culture and genetics), individual resources (cost factors, time, and social support), lack of providers or providers specializing in T2D, and environmental factors (lack of diabetes education, nutrition, and exercise programs) were found to affect Hispanics with T2D access to care. Conclusion: Cost factors, time, lack of social support, providers, and relevant programs remain prevalent barriers. As the Hispanic population increases and changes in the health care system are evolving, additional barriers to access to care are likely to emerge and must be explored.