Evidence map›Paper›PMID 27884848›Full record

SynthesisBMJ open2016

Are differences in travel time or distance to healthcare for adults in global north countries associated with an impact on health outcomes? A systematic review.

Charlotte Kelly, Claire Hulme, Tracey Farragher, Graham Clarke

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 288 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
288citing papers in PubMed, 4 pooled it
52.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

288 citing papers in PubMed, 4 syntheses or guidelines pooled it, 586 citations in OpenAlex.

  1. Pooled it
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  5. The role of the Clubhouse model in addressing health inequalities in rural Wyoming: a qualitative study.International journal of qualitative studies on health and well-being · 2026
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  9. Rural Patients' Transitional Care Experiences: A Qualitative Analysis of Provider Notes.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026
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  12. Burden of Travel is not Associated with Adherence to Follow-up Appointments - A Call for Centralization of Cleft Care in Germany.The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association · 2026
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228 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Charlotte KellyLeeds Institute of Health Sciences, University of Leeds, Leeds, UK.
Claire HulmeLeeds Institute of Health Sciences, University of Leeds, Leeds, UK.
Tracey FarragherLeeds Institute of Health Sciences, University of Leeds, Leeds, UK.
Graham ClarkeSchool of Geography, University of Leeds, Leeds, UK.
University of Leeds · GB

Funding

Department of Health DRF-2013-06-141
6 · The paper itself

Abstract

objectivesTo investigate whether there is an association between differences in travel time/travel distance to healthcare services and patients' health outcomes and assimilate the methodologies used to measure this.

designSystematic Review. We searched MEDLINE, Embase, Web of Science, Transport database, HMIC and EBM Reviews for studies up to 7 September 2016. Studies were excluded that included children (including maternity), emergency medical travel or countries classed as being in the global south. SETTINGS: A wide range of settings within primary and secondary care (these were not restricted in the search).

results108 studies met the inclusion criteria. The results were mixed. 77% of the included studies identified evidence of a distance decay association, whereby patients living further away from healthcare facilities they needed to attend had worse health outcomes (eg, survival rates, length of stay in hospital and non-attendance at follow-up) than those who lived closer. 6 of the studies identified the reverse (a distance bias effect) whereby patients living at a greater distance had better health outcomes. The remaining 19 studies found no relationship. There was a large variation in the data available to the studies on the patients' geographical locations and the healthcare facilities attended, and the methods used to calculate travel times and distances were not consistent across studies.

conclusionsThe review observed that a relationship between travelling further and having worse health outcomes cannot be ruled out and should be considered within the healthcare services location debate.

Indexed as

Health Services AccessibilityHumansOutcome and Process Assessment, Health CareTime FactorsTravelAccess to HealthcareHealth OutcomesSystematic Review

Identifiers

PMID27884848
PMCPMC5178808
OpenAlexW2551208445

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.