Addressing barriers to primary care access for latinos in the u.S. An agent-based model

Objective: Disparities in access to primary health care have led to health disadvantages among Latinos and other non-White racial groups. To better identify and understand which policies are most likely to improve health care for Latinos, we examined differences in access to primary care between Latinos with proficient English language skills and Latinos with limited English proficiency (LEP) and estimated the extent of access to primary care providers (PCPs) among Latinos in the U.S. Method: We used agent-based modeling techniques to estimate the effects of English proficiency, insurance coverage, Latinos with LEP seeking care from English-speaking PCPs, distance to PCP, PCP availability, and Spanish-speaking PCP availability on access to primary care. We used NetLogo 6.0 to simulate a community of 10,000 Latinos seeking care for a 6-month period, running 5 controlled experiments to determine if population-level outcomes varied by scenario. Results: Models suggested that Latinos with LEP would likely delay care less often if policies were implemented to expand health insurance coverage, address linguistic barriers and promote an inclusive health care climate for patients with LEP, reduce mobility barriers, increase the number of PCPs, and train more Spanish-speaking PCPs. Conclusions: Findings support results from prior studies suggesting that policies and programs that help Latino patients overcome linguistic and cultural barriers to health care will improve Latinos’ access to care.