PB0544 - Barriers in access to health care for children with hemophilia: a scoping review.

Background: Hemophilia affects approximately 400,000 people globally but many patients under 18 years old do not receive adequate treatment. Existing barriers in access to health care negatively impact patients’ health, quality of life, and life expectancy.

Aims: To assess and summarize key patterns in the literature on the barriers in access to health care experienced by children with hemophilia in different countries in the world.

Methods: A barrier was defined as anything that restricts the use of health services by making it more difficult for some individuals to access, use or benefit from care. The scoping review followed the JBI methodological guidance for Scoping Reviews and PRISMA-ScR. CINAHL, Ovid MEDLINE, and Global Health databases were searched. For each study included, characteristics including country of origin, type of study design, population age, and barrier(s) were extracted. Studies were grouped by the type of barrier identified (educational, financial, physical, psychological, socio-cultural, other). Contextual factors and broad findings were summarized.

Results: 7076 publications were screened by abstracts and titles, 153 studies were included for full-text review, and 30 studies were included for data extraction (Figure 1). A total of 76 barriers were identified: financial (n=17), educational (n=15), psychosocial (n=12), physical (n=7), and socio-cultural (n=2). This review found the major barrier is high cost of treatment and other financial concerns, followed by inadequate knowledge among families and health care professionals, psychosocial barriers in children, and poor adherence in children.

Conclusion(s): This review identified a wide range of barriers in access to health care for children with hemophilia. The breadth and depth of this scoping review highlighted areas that can be targeted to address, minimize, and overcome barriers and provides a focus for future research.