Rurality predisposes departure from gold-standard care, leading to delayed or accelerated access to surgery: insights from a scoping review.

Background: Because tertiary centres are generally situated at urban sites, it is unclear whether patients in rural areas have the same access to surgical services that patients in urban areas do. We sought to map the North American evidence landscape of how rurality affects access to medically indicated surgeries and identify system-, patient-, and provider-level barriers that preclude urban-comparable care.

Methods: We carried out a systematic search adhering to PRISMA for Scoping Reviews methodology across PubMed, MEDLINE, Scopus, and Web of Science, encompassing literature from the last 26 years (January 2023).