Cultural and Social Factors Influencing Orthopedic Health Care Experiences Among Haitian Patients in the Dominican Republic - An Exploratory Qualitive Study.

To explore the cultural, social, and economic factors influencing Haitian patients' decisions when seeking orthopedic care in the Dominican Republic, and to understand how these factors shape healthcare-seeking behavior and access to services. A single-center, cross-sectional qualitative survey was conducted at a tertiary trauma hospital in Santo Domingo between March and July 2025. Semi-structured interviews with both open and closed-ended questions were performed in Haitian Creole with the assistance of a translator. Adult Haitian patients attending outpatient consultations or scheduled for orthopedic surgery were included. Interviews were audio-recorded and reviewed repeatedly, and responses were organized descriptively into key domains. Fourteen patients participated. Most participants were working-age adults with low educational levels, and among those interviewed, migration was primarily attributed to economic and political instability rather than healthcare needs. Participants demonstrated a strong preference for formal medical care and generally reported positive perceptions of quality and equity in the healthcare services they received. However, important barriers were identified, including language limitations, financial constraints related to implants and medications, and cultural beliefs-particularly fear of amputation. Despite these challenges, trust in the healthcare system remained high. This study identified language barriers, financial constraints, and cultural beliefs as important factors influencing the orthopedic healthcare experiences of Haitian patients. Participants generally expressed positive attitudes toward orthopedic care and reported trust in the healthcare services they received in the Dominican Republic.