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

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.