Experiences of People with Disabilities and Chronic Illnesses Accessing Healthcare in Rural and Remote Communities: A Scoping Review

Abstract

Background: Rural and remote communities face well-documented challenges in healthcare access, including workforce shortages and long travel distances. For disabled people and people living with chronic illness, these challenges are compounded by accessibility barriers, fragmented services, and heightened dependence on accommodations, supports, and continuity of care.

Objective: This scoping review aimed to map the literature on how disabled people and people with chronic illness experience accessing healthcare in rural and remote settings, with attention to barriers, facilitators, care pathways, and patient-identified priorities for improvement.

Methods: Following the PRISMA-ScR framework, we systematically searched MEDLINE, Embase, CINAHL, PsycINFO, and Scopus from inception to July 2025. Eligible studies included qualitative, quantitative, and mixed-methods research describing healthcare access experiences among disabled people and/or individuals with chronic illness living in rural or remote regions. Data were charted on population, geography, care setting, access dimensions, and reported outcomes, and were synthesized using descriptive and thematic analysis.

Results: Twenty-five studies were included, spanning primary care, specialty care, rehabilitation, home care, and emergency services across rural and remote regions in high-, middle-, and select low-income settings. Four themes emerged: (1) distance, transportation, and the “time tax” of care; (2) service scarcity and discontinuity across the care journey; (3) accessibility and accommodation gaps within rural health systems; and (4) relational, cultural, and privacy dynamics shaping care-seeking and trust. Across studies, telehealth and local “wraparound” relationships were frequently described as partial mitigations, but often limited by broadband access, disability-related communication needs, and reduced opportunities for hands-on assessment.

Conclusion: Disabled and chronically ill people in rural and remote communities face layered access barriers that extend beyond geography to include accessibility, continuity, and the social realities of rural life. Future research should evaluate interventions that combine accessible transportation supports, strengthened local interdisciplinary capacity, disability-competent telehealth, and coordinated pathways for specialty and rehabilitation care.