(In)Equitable Access to Rehabilitation Services: A Scoping Review with Implications for Rehabilitation Researchers...

Lack of access to rehabilitation perpetuates health inequities in equity-denied groups, but evidence on populations most affected by inequitable access to rehabilitation is fragmented. We conducted a scoping review using the Joanna Briggs Institute methodology to identify groups experiencing inequities, barriers to access, the methods used to study (in)equitable access and the interventions used to address it.

We searched MEDLINE (via Ovid), Embase (via Ovid), and CINAHL (via EBSCOhost) for studies investigating equitable access to rehabilitation.

We screened titles, abstracts, and full texts against predefined eligibility criteria. Out of 3674 articles identified, 209 studies met the inclusion criteria.

Data were extracted on study characteristics (eg, country of origin), target populations, methodology, barriers to access, and intervention types. The extracted data were organized and categorized using the PROGRESS-Plus equity framework and the Candidacy 2.0 conceptual framework.

Most included studies were conducted in the United States (n=115), Australia (n=32), and Canada (n=26). Most included studies compared access between groups (eg, Black/White) (n=130), explored barriers to access (n=26), or examined the impact of rehabilitation policies (n=22). The most commonly reported barriers were the cost of services (n=12) and transportation (n=11).

There is an abundance of literature demonstrating disparities in access, with very little research focused on improving access. More robust data infrastructure, including data on structural determinants of health would provide a more nuanced understanding of access to rehabilitation for equity-denied groups.