Impact of distance and/or travel time on healthcare service access in rural and remote areas: A scoping review

Abstract

INTRODUCTION: People living in rural and remote communities often have to travel long distances to access healthcare services. However, the complex relationship between distance and/or travel time and healthcare service access remains unclear. This scoping review of the literature aimed to further understand the nuances between distance and/or travel time and rural and remote residents’ access to healthcare services in developed countries. METHODS: A review of published research papers from OECD countries cited in five databases (PubMed, PsycINFO, Medline, CINAHL and Scopus) between 1993 and mid-2023. RESULTS: From a total of 1418 articles identified, 135 met study inclusion criteria. One hundred and thirteen (83.7%) studies showed evidence of distance and/or travel time decay. Distance and/or travel time decay occurred at a distance as short as 16.1 km or 30 min, and as great as 90-100 km or 60 min. Studies showed that rural and remote residents travel further and longer to access specialist rather than generalist health services. CONCLUSIONS: Distance and travel time are important considerations for rural and remote residents of OECD countries when accessing healthcare services. Travel time may be a more meaningful measure than distance when assessing healthcare access decisions in non-metropolitan populations. Further well-designed research is needed to better understand under what circumstances rural and remote people will travel for healthcare services.