ABSTRACT
PURPOSE: This scoping review examined the methodologies used to measure access to care in serious injury-related disability populations, for whom access to care post-discharge has significant implications for patient outcomes and rehabilitation trajectories. METHODS: Four electronic databases were searched for literature published between 1 January 2000 and 15 February 2022. Relevant articles needed to relate to access to care in adult community-dwelling trauma and rehabilitation populations. RESULTS: The initial search identified 679 articles. Following de-duplication, the title/abstract screening was completed on 533 articles, and 56 full-text articles were reviewed. Thirty-eight articles met the eligibility criteria and were included in this review. Of the 38 studies included, there was large heterogeneity in the methodologies used to measure access to care. Two articles used multidimensional measures of access to care. CONCLUSIONS: There is an urgent need to establish the use of multidimensional measures as standard practice in access-to-care research. Failure to account for the multidimensional nature of access to care limits the full realisation of access for people with serious injury-related disability and prevents the implementation of processes that could improve access to health, rehabilitation, and support services and enhance the quality of care for individuals with a serious injury-related disability.
A consistently comprehensive approach to rehabilitation research will provide clearer insight into users' experiences and how to optimise their engagement with services.Multidimensional measures of access to care need to be developed, validated, and used to capture the complexity of access to rehabilitation care and what is important to users.More comprehensive evidence can strengthen consensus on the gold standard of what must be included in the measurement of access to rehabilitation care, to improve service reach and relevance.
