Narrative review highlights systemic barriers and inequities in medical travel for rural communities, emphasizing Indigenous considerations.
Introduction: Canadians living in rural and remote areas often face extensive travel to access health care services unavailable in their communities. This review examines the challenges of medical travel, focusing on systemic barriers and equity in health care delivery. Methods: Using a rapid review methodology, we analyzed Canadian publications from 2014 to 2024 that examined the experiences of patients and families who must travel for medical care that is not available in their rural community. An Indigenous physician provided insights into each article's implications for Indigenous populations. Results: Twenty original studies involving approximately 38,079 rural voices were reviewed. Key challenges identified were summarized in five themes: transportation struggles, out-of-pocket cost of medical travel, the impact of medical travel on mental health, communication issues and continuity of care, and the Indigenous context. Discussion: This review proposes a five C's framework for improvement: coordination of care, communication, comprehensive coverage, cultural safety, and cutting-edge technology. Key recommendations include developing rural infrastructure, creating culturally safe health care, expanding telehealth, and leveraging innovative technologies to reduce travel needs. By addressing systemic issues from an intersectional lens, implementing thoughtful policies, and leveraging technology, a healthier and more equitable future can be achieved, regardless of geographical location. A collaborative effort involving governments, health care providers, and community leaders is essential for tailoring solutions to the unique challenges faced by each region.
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Anish et al. (2025) studied this question.
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