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

Objective To explore rural hospital doctors’ experiences of providing care in New Zealand rural hospitals.Design The study had a qualitative design, using qualitative content analysis.Setting The study was conducted in South Island, New Zealand, and included nine different rural hospitals.Respondent...

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Main Authors: Tim Stokes, Fiona Doolan-Noble, Margareta Brännström, Mante Hedman
Format: Article
Language:English
Published: BMJ Publishing Group 2022-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/12/12/e062968.full
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author Tim Stokes
Fiona Doolan-Noble
Margareta Brännström
Mante Hedman
author_facet Tim Stokes
Fiona Doolan-Noble
Margareta Brännström
Mante Hedman
author_sort Tim Stokes
collection DOAJ
description Objective To explore rural hospital doctors’ experiences of providing care in New Zealand rural hospitals.Design The study had a qualitative design, using qualitative content analysis.Setting The study was conducted in South Island, New Zealand, and included nine different rural hospitals.Respondents Semistructured interviews were conducted with 16 rural hospital doctors.Results Three 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.Conclusions This 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.
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spelling doaj-art-abbfa5b701e54c4c8e85c342cdf0984e2025-08-20T03:52:41ZengBMJ Publishing GroupBMJ Open2044-60552022-12-01121210.1136/bmjopen-2022-062968Doctors’ experiences of providing care in rural hospitals in Southern New Zealand: a qualitative studyTim Stokes0Fiona Doolan-Noble1Margareta Brännström2Mante Hedman3General Practice & Rural Health, Otago University, Dunedin, New ZealandDepartment of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand3 Department of Nursing, Umeå Universitet, Skellefteå, Sweden1 Public Health and Clinical Medicine, Umea University, Umeå, SwedenObjective To explore rural hospital doctors’ experiences of providing care in New Zealand rural hospitals.Design The study had a qualitative design, using qualitative content analysis.Setting The study was conducted in South Island, New Zealand, and included nine different rural hospitals.Respondents Semistructured interviews were conducted with 16 rural hospital doctors.Results Three 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.Conclusions This 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.https://bmjopen.bmj.com/content/12/12/e062968.full
spellingShingle Tim Stokes
Fiona Doolan-Noble
Margareta Brännström
Mante Hedman
Doctors’ experiences of providing care in rural hospitals in Southern New Zealand: a qualitative study
BMJ Open
title Doctors’ experiences of providing care in rural hospitals in Southern New Zealand: a qualitative study
title_full Doctors’ experiences of providing care in rural hospitals in Southern New Zealand: a qualitative study
title_fullStr Doctors’ experiences of providing care in rural hospitals in Southern New Zealand: a qualitative study
title_full_unstemmed Doctors’ experiences of providing care in rural hospitals in Southern New Zealand: a qualitative study
title_short Doctors’ experiences of providing care in rural hospitals in Southern New Zealand: a qualitative study
title_sort doctors experiences of providing care in rural hospitals in southern new zealand a qualitative study
url https://bmjopen.bmj.com/content/12/12/e062968.full
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