Doctors’ experiences of providing care in rural hospitals in Southern New Zealand: a qualitative study

ObjectiveTo explore rural hospital doctors’ experiences of providing care in New Zealand rural hospitals.DesignThe study had a qualitative design, using qualitative content analysis.SettingThe study was conducted in South Island, New Zealand, and included nine different rural hospitals.RespondentsSe...

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Vydáno v:BMJ open Ročník 12; číslo 12; s. e062968
Hlavní autoři: Hedman, Mante, Doolan-Noble, Fiona, Stokes, Tim, Brännström, Margareta
Médium: Journal Article
Jazyk:angličtina
Vydáno: England British Medical Journal Publishing Group 06.12.2022
BMJ Publishing Group LTD
BMJ Publishing Group
Edice:Original research
Témata:
Adult palliative care
Codes
Content analysis
Delivery of Health Care
GERIATRIC MEDICINE
Health & safety
Health Services Research
Hospitalization
Hospitals
Hospitals, Rural
Humans
Interviews
Medical referrals
Medicine
New Zealand
Organisation of health services
Patients
Physicians
QUALITATIVE RESEARCH
Rural areas
Rural health care
New Zealand
Health & safety
Adult palliative care
QUALITATIVE RESEARCH
GERIATRIC MEDICINE
Organisation of health services
ISSN:2044-6055, 2044-6055
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Popis
Shrnutí:ObjectiveTo explore rural hospital doctors’ experiences of providing care in New Zealand rural hospitals.DesignThe study had a qualitative design, using qualitative content analysis.SettingThe study was conducted in South Island, New Zealand, and included nine different rural hospitals.RespondentsSemistructured interviews were conducted with 16 rural hospital doctors.ResultsThree themes were identified: ‘Applying a holistic perspective in the care’, ‘striving to maintain patient safety in sparsely populated areas’ and ‘cooperating in different teams around the patient’. Rural hospital care more than general hospital care was seen as offering a holistic perspective on patient care based on closeness to their home and family, the generalist perspective of care and personal continuity. The presentation of acute life-threatening low-frequency conditions at rural hospitals were associated with feelings of concern due to limited access to ambulance transportation and lack of experience.Overall, however, patient safety in rural hospitals was considered equal or better than in general hospitals. Doctors emphasised the central role of rural hospitals in the healthcare pathways of rural patients, and the advantages and disadvantages with small non-hierarchical multidisciplinary teams caring for patients. Collaboration with hospital specialists was generally perceived as good, although there was a sense that urban colleagues do not understand the additional medical and practical assessments needed in rural compared with the urban context.ConclusionsThis study provides an understanding of how rural hospital doctors value the holistic generalist perspective of rural hospital care, and of how they perceive the quality and safety of that care. The long distances to general hospital care for acute cases were considered concerning.
Bibliografie:Original research
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2022-062968