Access to Care among Hispanic/Latin American Patients in Neuropsychology: Addressing Potential Barriers to Appointment Adherence

Objective We will review barriers impacting access to care among Hispanic/Latin American patients, focusing on factors contributing to no-shows and possible interventions. Method We implemented an appointment management system to improve attendance using native Spanish speakers when indicated. We then recorded demographic data and attendance from 211 consecutive Hispanic/Latin American patients (123 females/88 males; mean age = 55 years, SD = 17.3; mean years formal education = 8.7, SD = 4.5). These were from a study of 537 patients in which we conducted MANOVA assessing the relationship between attendance and age, education, proxy income, and prior no-show rate, and Chi-Squares assessing associations between appointment status and gender, payor, race/ethnicity, MyChart Activation, and availability of collaterals. Among Hispanic/Latin American patients, we assessed associations between appointment status and language, MyChart activation, and availability of collaterals. Results Our system improved attendance, though no-shows remained high (17% among Latin American/Hispanic patients) with significant associations between attendance and language (χ2 = 9.884, p = 0.007), MyChart access and language (χ2 = 11.315 p = 0.004), and availability of collaterals and language (χ2 = 8.785, p = 0.012). Being monolingual Spanish speaking was associated positively with collateral availability (p < 0.05), while the relationships between language and attendance and between language and MyChart activation were complex. In the larger sample, older age, higher prior no-show rates, and no MyChart activation were associated with poorer appointment attendance; education and availability of collaterals were not. Conclusion There are potentially modifiable targets to improve attendance and access to care. We are now developing a health-fair model to teach patients the importance of attendance, assisting them with MyChart, transportation, and other resources.