eP813 - Barriers To Accessing Healthcare For Patients With Colorectal Disease In One Of The Lowest Income Zip Codes In The Nation

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Purpose/Background: Social determinants of health have been increasingly recognized as an important cause of disparate healthcare outcomes, particularly in vulnerable populations. Though it has been well established that there is significant inequity in access to healthcare among different populations, specific barriers and their relative significance are yet to be established, particularly among the Black and Hispanic populations. The emergence of COVID in recent years has also greatly affected healthcare accessibility, disproportionately affecting these minority groups. This study proposes to identify these socioeconomic determinants and their relative importance in our population.Methods/Interventions: All adults admitted with chronic colorectal disease over a 3-month time period as identified from inpatient records are planned for inclusion in the study. Both malignant and chronic benign conditions like diverticulitis, colonic fistulae, anorectal abscess/ complex anorectal fistulae are included. Patients are given a questionnaire comprising demographic and socioeconomic information along with questions related to specific barriers to healthcare access; this study is currently accruing at time of abstract submission. As a pilot project, we administered this questionnaire to 10 eligible patients presenting to our general surgery clinic. Completed questionnaires were anonymously placed in a sealed box and data was tabulated via Excel.Results/Outcomes: Patients participating in our pilot project were majority male (60%), ranging in age from 20-70 years. They identified predominantly as Hispanic (70%) or Black (20%), with 50% of them preferring to communicate in Spanish. Only 30% were educated beyond high school, 40% were full time employed and 50% had a total household income of less than 30,000 dollars. A significant percentage of patients identified lack of community support, unreliable transportation or inadequate family support as major barriers to care. Other less common but serious barriers included lack of access to paid time off, inadequate understanding of condition/treatment plans and difficulty with insurance coverage (as detailed in the table below). Regarding suggestions to improve care, 50% felt they would benefit from a written document detailing their condition, while a similar number felt tele-visits would be helpful.Conclusion/

Discussion: We anticipate that by identifying the main socioeconomic barriers to accessing healthcare in our colorectal population- which is largely comprised of vulnerable population groups- we will be able to institute targeted measures to address the most significant barriers. This will allow us to start to remove the inequity in healthcare access that they face, while improving outcomes.Table 1Identified barriers to health care access in our population