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超越患者护理:一项农村医院改善社区健康作用的定性研究。

Beyond patient care: a qualitative study of rural hospitals' role in improving community health.

机构信息

Department of Surgery, Division of Surgical Oncology, CHDS, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

Department of Health Policy and Management, Fileding School of Public Health, UCLA, Los Angeles, California, USA.

出版信息

BMJ Open. 2022 Mar 16;12(3):e057450. doi: 10.1136/bmjopen-2021-057450.

Abstract

OBJECTIVES

Rural population face more health disadvantages than those living in urban and suburban areas. In rural communities, hospitals are frequently the primary organisation with the resources and capabilities to address health issues. This characteristic highlights their potential to be a partner and leader for community health initiatives. This study aims to understand rural hospitals' motivations to engage in community health improvement efforts and examine their strategies to address community health issues.

DESIGN

Eleven semistructured interviews were conducted with key leaders from four rural hospitals in a US Midwestern state. On-site and telephone interviews were audio-recorded and transcribed. The combination of inductive and deductive qualitative analysis was applied to identify common themes and categories.

SETTINGS

Participating hospitals are located in US rural counties that have demonstrated progress in creating healthier communities.

RESULTS

Three types of motivation drive rural hospitals' community health improvement efforts: internal values, economic conditions and social responsibilities. Three categories of strategies to address community health issues were identified: building capacity, building relationships and building programmes.

CONCLUSIONS

Despite the challenges, rural hospitals can successfully conduct community-oriented programmes. The finds extend the literature on how rural hospitals may strategise to improve rural health by engaging their communities and conduct activities beyond patient care.

摘要

目的

农村人口面临着比城市和郊区人口更多的健康劣势。在农村社区,医院通常是拥有资源和能力来解决健康问题的主要组织。这一特点突出了它们作为社区卫生倡议的合作伙伴和领导者的潜力。本研究旨在了解农村医院参与社区卫生改善工作的动机,并探讨其解决社区卫生问题的策略。

设计

在美国中西部一个州的 4 家农村医院的 11 名关键领导人进行了半结构化访谈。现场和电话访谈进行了录音并转录。采用归纳和演绎相结合的定性分析方法,确定了常见的主题和类别。

环境

参与的医院位于美国农村县,这些县在创建更健康社区方面取得了进展。

结果

有三种动机推动农村医院进行社区卫生改善工作:内部价值观、经济条件和社会责任。确定了三种解决社区卫生问题的策略类别:能力建设、关系建设和方案建设。

结论

尽管存在挑战,但农村医院可以成功开展面向社区的项目。这些发现扩展了关于农村医院如何通过参与社区和开展超越患者护理的活动来制定改善农村健康的策略的文献。

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