RT Journal Article
SR Electronic
T1 Rural Patient Experiences of Accessing Care for Chronic Conditions: A Systematic Review and Thematic Synthesis of Qualitative Studies
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 266
OP 272
DO 10.1370/afm.2798
VO 20
IS 3
A1 Elizabeth H. Golembiewski
A1 Derek L. Gravholt
A1 Victor D. Torres Roldan
A1 Eddy P. Lincango Naranjo
A1 Sebastian Vallejo
A1 Andrea Garcia Bautista
A1 Christina M. LaVecchia
A1 Christi A. Patten
A1 Summer V. Allen
A1 Soumya Jaladi
A1 Kasey R. Boehmer
YR 2022
UL http://www.annfammed.org/content/20/3/266.abstract
AB PURPOSE Access to health care is a long-standing concern for rural patients; however, administrative measures fail to capture the subjective patient experience of accessing health care. The purpose of this review was to synthesize the qualitative literature on patient and caregiver experiences of accessing health care services for chronic disease management among US residents of rural areas.METHODS We searched Embase, MEDLINE, PsycInfo, CINAHL, and Scopus to identify qualitative studies published during 2010-2019. A thematic synthesis approach was used to analyze findings from included studies.RESULTS A total of 62 studies involving 1,354 unique participants were included. The largest share of studies (24.2%) was focused on the experience of patients with cancer, followed by behavioral health (16.1%), HIV and AIDS (14.5%), and diabetes (12.9%). We identified 4 primary analytic themes of barriers and facilitators associated with the experience of accessing health care services for chronic disease management in rural areas: (1) navigating the rural environment, (2) navigating the health care system, (3) financing chronic disease management, and (4) rural life (ie, common elements of a distinct “rural” way of thinking and behaving).CONCLUSIONS In this comprehensive review, we found that important cultural, structural, and individual factors influenced the rural patient’s experience of health care access and use, including barriers and facilitators posed by geographic and built environments, and distinct rural mores. Our findings can inform policies and programs that both facilitate structural aspects of access and include culturally appropriate interventions.VISUAL ABSTRACT