Perceived Access to Endometriosis Care Among Hispanic Women: A Cross-Sectional Survey

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Primary objective We evaluated perceived access to endometriosis-related care among Hispanic and non-Hispanic women with endometriosis. Secondary objectives We compared referral experiences, financial barriers, geographic access, and specialist access between Hispanic and non-Hispanic women and between women residing within and outside of the United States. Design This was a cross-sectional, anonymous, web-based survey. Setting This was an international, online survey including participants in and outside of the United States. Participants A total of 288 adults aged ≥18 years with suspected or confirmed endometriosis, fluent in English or Spanish, were recruited in the study. Interventions None. Measurements and main results The primary outcome was perceived access to care. Across all groups, fewer than one-third of respondents reported adequate access to knowledgeable endometriosis clinicians, with no significant differences observed when comparing U.S. Hispanic (p=0.99) or non-U.S. Hispanic (p=0.10) participants to the U.S. non-Hispanic reference group. Secondary outcomes revealed significant differences in access-related experiences between groups. Hispanic participants were less likely to have been evaluated by an endometriosis specialist when comparing non-U.S. Hispanics and U.S. non-Hispanics only: 47 (55%) vs. 92 (75%), respectively (p=0.002). Diagnostic delays were common, with most participants reporting more than five years between symptom onset and diagnosis. Although not significant, approximately one-third or more of participants across groups reported consulting more than five providers before diagnosis (9 (32%) U.S. Hispanics to 33 (65%) non-U.S. non-Hispanics). Difficulty obtaining referrals was more commonly reported among Hispanic respondents, as seen in 17 (61%) U.S. Hispanics and 68 (79%) non-U.S. Hispanics reporting difficulty compared to 49 (40%) U.S. non-Hispanics (p=0.04 and p<0.001, respectively). Non-U.S. Hispanics reported greater financial barriers, 60 (70%) non-U.S. Hispanics to 65 (53%) U.S. non-Hispanics (p=0.01). Geographic access varied: U.S. Hispanics were less likely to require out-of-state travel, 2 (7%) U.S. Hispanics to 32 (26%) U.S. non-Hispanics (p=0.04), whereas non-U.S. Hispanics more often required cross-border travel, with 34 (40%) to 32 (26%) U.S. non-Hispanics (p=0.04). Conclusion Hispanic respondents in this survey, particularly those living outside the US, reported substantial barriers to endometriosis care, including limited specialist access, referral challenges, financial strain, and travel burden. These findings suggest potential targets for future interventions, including referral pathways, specialist availability, and patient navigation, which warrant further evaluation.

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