Call for better understanding of rural hospitals' unique role in the pandemic

Publicly released:
New Zealand

Interviews with 17 senior doctors in New Zealand rural hospitals, from late 2020, have revealed variable support from district health boards on the Covid-19 response. They said DHB understanding of rural hospital facilities and processes was poor, but pre-existing relationships did help. All these doctors felt ongoing uncertainty remained over managing and transferring acutely-unwell Covid patients. The authors say that rural hospitals - though poorly understood - have specialist expertise and are uniquely placed to improve health equity for rural communities, particularly for Māori and Pacific peoples.

News release

From: New Zealand Medical Association (NZMA)

Exploring the response to the COVID-19 pandemic at the rural hospital–base hospital interface: experiences of New Zealand rural hospital doctors

Summary

In many overseas countries, those living in rural areas have experienced poorer health outcomes as a consequence of the COVID-19 pandemic than their compatriots living in cities. This study interviewed 17 senior doctors in different New Zealand rural hospitals about their experience planning for the pandemic in its early stages. This study considered their interactions with the local DHB and base hospital. There was considerable variability in how well the rural doctors felt supported by their DHB. It was common to feel both forgotten by the DHB and at the same time overwhelmed by masses of often contradictory information that was not always relevant to their situation. Established clinical leadership and a stable workforce aided pandemic preparations, as did pre-existing high quality relationships with the local DHB. The rural doctors were concerned about the ability of their local facilities to handle large numbers of seriously unwell and highly infectious patients, but were even more concerned about the ability of the system to transport those needing advanced care to the base hospital.  Having the needs of rural health considered at a national level, rather than DHB by DHB, could have improved the response. Many were very relieved that the system had not been tested the way it has been in other countries.

Journal/
conference:
NZMJ
Organisation/s: University of Otago
Funder: N/A
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