Background The challenge of including citizen-patient voices in healthcare planning is exacerbated in rural communities by regional variation in priorities and a historical lack of attention to rural healthcare needs. This paper aims to address this deficit by presenting findings from a mixed methods study to understand rural patient and community priorities for healthcare. Methods We conducted a provincial survey of rural citizens-patients across British Columbia, Canada to understand their most pressing healthcare needs, supplemented by semi-structured interviews. Survey and interview participants were asked to articulate, in their own words, their communities’ most pressing healthcare needs, to explain the importance of these priorities to their communities, and to offer possible solutions to address these challenges. Open-text survey responses and interview data were analyzed thematically to elicit priorities of the data and their significance to answer the research questions. Results We received 1,287 survey responses from rural citizens-patients across BC, 1,158 of which were considered complete. We conducted nine telephone interviews with rural citizens-patients. Participants stressed the importance of local access to care, including emergency services, maternity care, seniors care, specialist services and mental health and substance use care. A lack of access to primary care services was the most pronounced gap. Inadequate local health services presented geographic, financial and social barriers to accessing care, led to feelings of vulnerability among rural patients, resulted in treatment avoidance, and deterred community growth. Conclusions Two essential prongs of an integration framework for the inclusion of citizen-patient voices in healthcare planning include merging patient priorities with population needs and system-embedded accountability for the inclusion of patient and community priorities.

Purpose Understanding the perception and practices of ophthalmologists for trachoma is important to develop interventions aimed at disease elimination in Egypt. The survey investigated: (1) the views and practice patterns of Egyptian ophthalmologists for trachoma and (2) the influence of geographic location, setting, and years of practice on ophthalmologists’ perceptions. Methods A questionnaire sent to ophthalmologists currently working in Egypt collected information on: (1) demographics, (2) caseload and practice patterns for trachoma, (3) 13 Likert scale questions regarding the current state of trachoma, and (4) two open-ended written response questions. Results Of the 500 recipients, 194 ophthalmologists participated. 98% of the respondents reported seeing trachoma patients in their practice. 28.8% agreed that trachoma is currently an active health problem in Egypt, with ophthalmologists in public practice having significantly higher agreement scores compared to private practitioners (p = 0.030). Rural ophthalmologists were significantly more likely to agree that a targeted trachoma control program is needed in their location of practice compared to their urban counterparts (p < 0.001). Open-ended questions revealed recurrent themes, including the rural distribution of trachoma patients and the high volume of patients with corneal opacity. Conclusion Ophthalmologists’ experiences with trachoma in Egypt differed based on practice setting, years in practice, and location, and the overall perception of the impact of the disease remains low. However, there was widespread agreement that trachoma is present in communities across the country. Practitioners in rural areas and in the public sector shared a disproportionate burden of the trachoma caseload. The perspectives of such ophthalmologists must be emphasized in decision-making related to trachoma interventions.

This audit explores readmissions into inpatient services for adults with intellectual disabilities, using two case studies. Thirteen semi-structured interviews were conducted with professionals, to gain a multidisciplinary perspective, between February and March 2010, and analysed using thematic analysis. The main themes found in case study 1 were: narrow focus, environment, communication, early discharge, and deterioration. The main themes found in case study 2 were: deterioration, communication, discharge too soon, and environment. The aims of the audit were to contribute to good practice and provide a better understanding of readmission within our services.

the 35 who had moved into it (excluding the six children who had moved away or had no records).Doctors who are enthusiastic immunisers in practices with a high turnover of children therefore have to work exceptionally hard, as immunised children who move away tend to be replaced by those who have not been immunised. Unfortunately, not even enthusiasts can give preschool boosters to children who have not completed the primary course.The practice's overall uptake of the preschool booster was disappointing at 68%, well below that of the primary course, which then averaged 85% across the new contract's three immunisation groups. The uptake has since been improved to 77% and can no doubt be improved further. For many practices, however, a target of 90% seems even more unreasonable for the preschool booster than for the primary course.