Wang Siyu, von Huben Amy, Sivaprakash Prithivi Prakash, Saurman Emily, Norris Sarah, Wilson Andrew
Faculty of Medicine and Health, Sydney School of Public Health, Leeder Centre for Health Policy, Economics and Data, The University of Sydney, Sydney, NSW, Australia.
Faculty of Medicine and Health, School of Rural Health (Dubbo/Orange) and Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.
Digit Health. 2025 Apr 1;11:20552076251326233. doi: 10.1177/20552076251326233. eCollection 2025 Jan-Dec.
To synthesize existing reviews on the impact of telehealth programs on health service equity in non-urban areas, focusing on six dimensions of access: accessibility, availability, acceptability, affordability, adequacy, and awareness.
We included systematic and non-systematic reviews published from 2012 to 2023 on telehealth interventions in rural or remote settings. Content was mapped to the six dimensions, and coverage within each dimension was rated based on predefined criteria.
A total of 42 reviews (43% systematic) were identified. Most reviews (90.5%) addressed at least one dimension, yet comprehensive coverage was rare. Acceptability had the highest number of "good" ratings (24%), while awareness was the least explored. Gaps included digital literacy, infrastructure challenges, and cultural barriers-factors critical to equitable telehealth access. Cost-effectiveness analyses were also limited, leaving affordability underexamined.
Telehealth shows promise for improving healthcare access in non-urban regions. However, existing reviews often provide incomplete assessments across the six dimensions. This suggests a need for clearer, more robust evaluation frameworks to ensure more comprehensive reporting of equity impacts in telehealth research.
综合现有关于远程医疗项目对非城市地区卫生服务公平性影响的综述，重点关注可及性的六个维度：可达性、可用性、可接受性、可负担性、充分性和认知度。
我们纳入了2012年至2023年发表的关于农村或偏远地区远程医疗干预措施的系统综述和非系统综述。内容映射到六个维度，并根据预定义标准对每个维度的覆盖情况进行评分。
共识别出42篇综述（43%为系统综述）。大多数综述（90.5%）涉及至少一个维度，但全面覆盖的情况很少见。可接受性获得“良好”评分的数量最多（24%），而认知度的研究最少。差距包括数字素养、基础设施挑战和文化障碍——这些因素对于公平的远程医疗可及性至关重要。成本效益分析也很有限，使得可负担性未得到充分研究。
远程医疗有望改善非城市地区的医疗服务可及性。然而，现有综述往往在六个维度上提供不完整的评估。这表明需要更清晰、更强大的评估框架，以确保在远程医疗研究中更全面地报告公平性影响。
