Rural hospital contributions to community health: community perspectives from a New Zealand rural hospital

Stephen Ram; Karen Carlisle; Sarah Larkins; Katharina Blattner

doi:10.1071/HC24058

RESEARCH ARTICLE (Open Access)

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Rural hospital contributions to community health: community perspectives from a New Zealand rural hospital

Stephen Ram

¹ ^* , Karen Carlisle ² , Sarah Larkins ² , Katharina Blattner

³

+ Author Affiliations

- Author Affiliations

¹ Tokoroa Hospital, Te Whatu Ora (Health New Zealand) Waikato District, Maraetai Road, Tokoroa, New Zealand.

² James Cook University, Townsville, Qld, Australia.

³ University of Otago, Dunedin, New Zealand.

^* Correspondence to: stephen.ram@my.jcu.edu.au

Journal of Primary Health Care 16(3) 278-287 https://doi.org/10.1071/HC24058

Submitted: 22 April 2024 Accepted: 24 June 2024 Published: 18 July 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

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.

Keywords: community participation, community-institutional relations, health services evaluation, Maori health, Pacific health, rural health, rural hospital.

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