Melissa Emily Cyr|Anna G. Etchin|Barbara Guthrie|James C. Benneyan
Access to specialty healthcare in urban versus rural US populations: a systematic literature review
Northeastern University|VA Boston Healthcare System|Northeastern University|Northeastern University
abstract background access healthcare poorly defined construct insufficient understanding differences facilitators barriers us urban versus rural specialty care summarize recent literature expand upon prior conceptual access framework adapted specifically urban rural specialty care methods systematic review conducted literature within cinahl medline pubmed psycinfo proquest social sciences databases published january 2013 august 2018 search terms targeted peerreviewed academic publications pertinent access us urban rural specialty healthcare exclusion criteria produced 67 articles findings organized existing tendimension care access conceptual framework possible additional topics grouped thematically supplemental dimensions results despite geographic demographic differences many access facilitators barriers common populations three dimensions contain literature addressing urban rural populations commonly represented dimensions availability accommodation appropriateness ability perceive four new identified dimensions government insurance policy health organization operations influence stigma primary care specialist influence conclusions findings generally align preexisting framework also suggest several additional themes important urban versus rural specialty care access