Health care access from the rural perspective: A narrative review

Area of Science:

• Health Services Research
• Rural Health
• Healthcare Access

Background:

• Existing healthcare access frameworks lack specificity for rural populations.
• Understanding rural health disparities is crucial for equitable care delivery.

Purpose of the Study:

• To describe healthcare access measurement using the Fortney model, focusing on rural populations.
• To identify differential impacts of access barriers on rural communities.

Main Methods:

• Utilized the Fortney model's five dimensions of access: geographic, temporal, financial, cultural, and virtual.
• Analyzed patient-level access within the context of community, provider, and health system environments.
• Compared access metrics between rural and urban populations.

Main Results:

• Rural populations face disproportionate geographic barriers (distance, transportation) and virtual access challenges (broadband, digital literacy).
• Healthcare workforce shortages and social determinants of health significantly impact rural access.
• Facilitators include integrated public transport, expanded broadband, and rural workforce support.

Conclusions:

• Healthcare systems must integrate access metrics for continuous improvement and equity.
• Unique approaches are necessary to address disproportionate rural access challenges.
• Ensuring equitable healthcare access for rural populations requires targeted interventions.