Urban and Rural Barriers to Healthcare Accessibility: A Systematic Literature Review

Presenter: Melissa Cyr

Research Category: Health Sciences
Student Type: null
Additional Authors: Barbara Guthrie, James Benneyan
PI: Melissa Cyr, James Benneyan

Background: Healthcare is an affirmed, fundamental human right; therefore, health promotion and attainment are essential to equity. Access to healthcare is a poorly defined construct, but necessary to effectively reach and utilize essential services to promote optimal health outcomes in vulnerable populations residing in urban or rural geographical areas.

Purpose: To provide an integrated summary of the recent literature regarding barriers to healthcare access among vulnerable urban and rural populations organized by a conceptual healthcare access framework.

Methods: A systematic review of three databases were utilized using search terms (health services accessibility) AND (urban OR rural), initially yielding 27,262 cumulative results. The inclusion criteria were: US based articles that included full text; peer-reviewed; English language articles; published from 2012 to 2016; that contained original research; clear delineation between urban and rural data; and knowledge on patient access and utilization barriers in healthcare. The exclusion criteria were duplicate and dental health articles.

Results: The conceptual framework was used to generate pervasive themes. Despite geographical and societal variability, many of the same themes were central to both populations. Additionally, this review generated further research questions: ‘Is there a difference between urban/rural access barriers within specialty care or certain patient populations?’ and ‘What influence do state, federal, institutional, and organizational policies have on the identified access variables?’

Conclusion: The majority of barriers between urban and rural populations were found to be overall similar with few differences. Barriers to healthcare accessibility are ubiquitous obstacles to achieving health equity in both urban and rural populations.