Tokoroa Hospital, Te Whatu Ora (Health New Zealand) Waikato District, Maraetai Road, Tokoroa, New Zealand.
James Cook University, Townsville, Qld, Australia.
J Prim Health Care. 2024 Sep;16(3):278-287. doi: 10.1071/HC24058.
Introduction Rural hospitals provide secondary care for much of the rural New Zealand population. Little is known about community perspectives of the health and social contribution. Aim This descriptive qualitative study aimed to explore community views on the role of their rural hospital in a low socioeconomic rural district with a high Māori and Pacific population. Methods Semi-structured individual and focus group interviews were conducted with rural community members about the perceived role of their rural hospital. Iterative thematic analysis was undertaken. Results In total, 22 participants were interviewed. Thematic analysis yielded four themes: (i) rural hospitals as a safety net - providing access to emergency care and mitigating limited primary care access; (ii) providing personalised, culturally aware care; (iii) facilitating family/whanau support; and (iv) doing the best with limited resources. The latter included pragmatism about resource constraints, but a preference for the hospital to remain open. Discussion Rural hospitals contribute to community safety by enhancing access to emergency care and mitigating difficulties in access to primary care. The local contextual knowledge of rural hospital providers allows personalised, family-centred and culturally-responsive care. Despite service centralisation, rural hospitals are wanted by their communities. Rural health planners should consider how to maximise the breadth of locally-provided services to reduce the impacts of travel and transfer for care.
介绍
农村医院为新西兰农村地区的大部分人口提供二级医疗服务。对于农村社区对其农村医院的健康和社会贡献的看法，人们知之甚少。
目的
本描述性定性研究旨在探索在一个具有高毛利人和太平洋人口的低社会经济农村地区，农村社区对其农村医院的作用的看法。
方法
对农村社区成员进行了关于他们的农村医院的感知作用的半结构化个体和焦点小组访谈。进行了迭代主题分析。
结果
共有 22 名参与者接受了采访。主题分析产生了四个主题：（i）农村医院作为安全网 - 提供紧急护理，缓解初级保健服务有限的问题；（ii）提供个性化、文化意识强的护理；（iii）促进家庭/家庭支持；（iv）在资源有限的情况下尽力而为。后者包括对资源限制的实用主义，但倾向于让医院保持开放。
讨论
农村医院通过提高对紧急护理的获取机会和缓解获取初级保健服务的困难，为社区安全做出了贡献。农村医院提供者的本地背景知识允许提供个性化、以家庭为中心和文化响应的护理。尽管服务集中化，农村医院仍然受到社区的欢迎。农村卫生规划者应考虑如何最大限度地扩大本地提供的服务范围，以减少因护理而产生的旅行和转移的影响。
