PT  - JOURNAL ARTICLE
AU  - Elizabeth H. Golembiewski
AU  - Derek L. Gravholt
AU  - Victor D. Torres Roldan
AU  - Eddy P. Lincango Naranjo
AU  - Sebastian Vallejo
AU  - Andrea Garcia Bautista
AU  - Christina M. LaVecchia
AU  - Christi A. Patten
AU  - Summer V. Allen
AU  - Soumya Jaladi
AU  - Kasey R. Boehmer
TI  - Rural Patient Experiences of Accessing Care for Chronic Conditions: A Systematic Review and Thematic Synthesis of Qualitative Studies
AID  - 10.1370/afm.2798
DP  - 2022 May 01
TA  - The Annals of Family Medicine
PG  - 266--272
VI  - 20
IP  - 3
4099  - http://www.annfammed.org/content/20/3/266.short
4100  - http://www.annfammed.org/content/20/3/266.full
SO  - Ann Fam Med2022 May 01; 20
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