Healthcare access is complex because it is intertwined with both health systems’ performance and patients’ perspectives. Differential access to healthcare is a key driver of physical and mental health disparities, particularly among vulnerable populations like the LGBTQIA+ community. Patients who identify as LGBTQIA+ suffer from diagnostic error and patient safety concerns at a greater rate than non-LGBTQIA+ individuals due to stigma and fear of discrimination in healthcare settings. Clinical environments that feel unwelcoming or unsafe stand as a significant barrier to healthcare seeking and access, however, these environments can be easily modified to ensure the delivery of gender-affirming and inclusive care. To assess acceptability of LGBTQIA+-patient care at Jefferson, an environmental scan was conducted in six ambulatory care settings to help identify structural barriers that contribute to an unwelcoming environment for this community. Site visits were conducted between December 2022 and January 2023, and observational data were recorded in Qualtrics using an environmental scan survey tool. Findings from the environmental scans suggest that providers and their offices are not doing enough to create gender-affirming environments for LGBTQIA+ patients. Some practical changes that can be made in Jefferson ambulatory care settings include placing a rainbow pride flag on the office door and/or printed materials, enhancing staff training on LGBTQ+ clinical care, and updating intake forms, surveys, and EHRs to include nontraditional gender identifications and information. These recommendations can also be applied throughout the Jefferson Health Enterprise to ensure acceptability of care for patients of all backgrounds.
Witkowski, Julia, "Evaluating Structural Barriers to Healthcare Access Relevant to the LGBTQIA+ Community" (2023). Master of Public Health Capstone Presentations. Presentation 472.