Related Experiment Video
Updated: Jul 15, 2026
Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
Impact of geographical location on ICU outcomes in adults: a scoping review
Jacob Zand1, Nattaya Raykateeraroj2, Je Min Suh1
1Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia.
Objectives:
Rural populations experience poorer health outcomes than urban counterparts globally. Limited studies have examined the impact of geographical location-specifically travel distance/time and rurality-on intensive care unit (ICU) outcomes. This scoping review aimed to map literature on geographical location and ICU outcomes to better inform policy and improve ICU access in underserved communities.
Design:
Scoping review.
Data Sources:
MEDLINE, CINAHL and Embase were searched through to 8 May 2025. Grey literature was identified through ProQuest Dissertations and Theses Global, including dissertations, theses and conference proceedings.
Eligibility Criteria For Selecting Studies:
Studies examining the impact of geographical location (rurality and/or travel distance/time) on ICU outcomes in adult populations were included. No restrictions were placed on country, healthcare setting or date of publication. Peer-reviewed primary studies and grey literature were eligible; editorials, commentaries and reviews were excluded.
Data Extraction And Synthesis:
Two reviewers independently extracted study characteristics, rurality definitions, travel distance/time measures and ICU outcomes using a standardised form and synthesised descriptively.
Results:
23 articles and 1 conference abstract; all were retrospective studies. 23 studies reported on rurality with 20 specifying the definition used. Six studies reported travel distance/time, all detailing measurement methods. 12 studies mentioned baseline patient comorbidities, 18 reported ICU admissions and 4 hospital/ICU readmissions. More studies reported longer ICU length of stay and greater ICU intervention use among rural compared with urban/metropolitan patients, although mortality findings were inconsistent. Heterogeneity limited direct comparison. No clear association was found between travel distance/time and ICU outcomes.
Conclusions:
Inconsistent rurality definitions complicated comparisons. The mapped literature reported longer ICU LOS and greater intervention use for rural compared with urban/metropolitan patients; however, mortality findings were inconsistent with no predictive pattern. No clear association was observed between travel distance/time and ICU outcomes. Future research should adopt standardised rurality definitions, account for preadmission health status and focus on condition specific contexts to inform policy.