Barriers to healthcare access for cognitively impaired older Hispanics

This study describes the development of the Barriers to Healthcare Access S urvey (BHAS) used to evaluate seven barrier factors believed to influence h ealthcare access Fur elderly Hispanics with memory or cognitive problems. T his study further reports the results: of the BHAS applied to a community s ample of cognitively impaired older Hispanics and their caregivers. The stu dy includes (1) The BHAS's development and procedures to establish instrume nt validity and reliability; (2) Interviews with the BHAS on 65 cognitively impaired Hispanics who were undergoing full diagnostic assessment for deme ntia and their caregivers. The most frequently perceived healthcare barrier s reported in our study were related to (1) personal beliefs (38%), (2) lan guage proficiency (33%), and (3) economic status (13%). The BHAS possesses the requisite psychometric properties to be an effective instrument for an initial survey of perceived barriers to access health care for low-educatio n, cognitively impaired, elderly Hispanic patients. The findings suggest th at perceptions regarding illness, health consequences of aging, and beliefs about the utility of medicine do, in fact, influence healthcare use by old er Hispanic patients with dementia. Language proficiency and economic statu s remain common barriers among elderly Hispanic subgroups, but when these b arriers are experienced by the cognitively impaired, serious healthcare imp lications: ensue, especially delay in early diagnosis and treatment.