Characteristics of High-Resource Health System Users in Rural and Remote Regions: A Scoping Review

Int J Environ Res Public Health. 2023 Apr 4;20(7):5385. doi: 10.3390/ijerph20075385.

Abstract

A small proportion of health care users are recognized to use a significantly higher proportion of health system resources, largely due to systemic, inequitable access and disproportionate health burdens. These high-resource health system users are routinely characterized as older, with multiple comorbidities, and reduced access to adequate health care. Geographic trends also emerge, with more rural and isolated regions demonstrating higher rates of high-resource use than others. Despite known geographical discrepancies in health care access and outcomes, health policy and research initiatives remain focused on urban population centers. To alleviate mounting health system pressure from high-resource users, their characteristics must be better understood within the context in which i arises. To examine this, a scoping review was conducted to provide an overview of characteristics of high-resource users in rural and remote communities in Canada and Australia. In total, 21 papers were included in the review. Using qualitative thematic coding, primary findings characterized rural high-resource users as those of an older age; with increased comorbid conditions and condition severity; lower socioeconomic status; and elevated risk behaviors.

Keywords: health care; health care costs; health services research; healthcare inequalities; public health systems research; rural health.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Australia
  • Canada
  • Health Services Accessibility*
  • Humans
  • Rural Health Services*
  • Rural Population
  • Urban Population

Grants and funding

This research was funded by Ontario Ministry of Health (Canada), through an Ontario Early Researcher Award (ERA) number ER18-14-064, Patient Experiences of High Health System Users in Rural Canada; and the Social Sciences and Humanities Research Council (Canada) Connection Grant number 611-2017-0548, Free Range International Knowledge Exchange.