Integrating telemedicine and community support to enhance healthcare access for people with disabilities: a SANRA-aligned narrative review

Abstract

People with disabilities face multiple barriers to healthcare access globally, especially in low-resource and underserved settings. Telemedicine and community-based care have emerged as potential strategies to reduce these gaps, but evidence remains fragmented. This narrative review aimed to examine barriers to healthcare access for people with disabilities and explore the role of telemedicine and community-based interventions. A narrative review was conducted following SANRA guidelines. Searches were performed in PubMed, MEDLINE, Scopus, Web of Science, CINAHL, PsycINFO, and Google Scholar. Fifty studies were included from 116 records using thematic synthesis. Reporting followed SANRA to ensure transparency and thematic synthesis rather than quantitative pooling. Findings show that barriers are structural, attitudinal, financial, informational, and systemic. Rural populations face additional geographic and transport challenges. Telemedicine improves access by reducing distance and cost, while community-based strategies strengthen outreach and continuity of care. However, the digital divide and system limitations reduce effectiveness. Evidence also shows that inequities are more severe in LMICs and rural regions due to weak infrastructure and limited resources. Caregiver dependence and policy implementation gaps further limit autonomy and access despite existing legal frameworks. The review highlights the need for integrated, context-specific approaches combining policy reform, digital health, and community support to improve equitable healthcare access for people with disabilities. Future efforts should prioritize inclusive service design, digital equity, and strengthening health systems in underserved settings to improve health outcomes for all globally.