Healthcare Providers’ Perceptions of Potentially Preventable Rural Hospitalisations: A Qualitative Study

Abstract

Potentially preventable hospitalisations (PPHs) are common in rural communities in Australia and around the world. Healthcare providers have a perspective on PPHs that may not be accessible by analysing routine patient data. This study explores the factors that healthcare providers believe cause PPHs and seeks to identify strategies for preventing them. Physicians, nurses, paramedics, and health administrators with experience in managing rural patients with PPHs were recruited from southern Tasmania, Australia. Semi-structured telephone interviews were conducted, and reflexive thematic analysis was used to analyse the data. Participants linked health literacy, limited access to primary care, and perceptions of primary care services with PPH risk. The belief that patients did not have a good understanding of where, when, and how to manage their health was perceived to be linked to patient-specific health literacy challenges. Access to primary healthcare was impacted by appointment availability, transport, and financial constraints. In contrast, it was felt that the prompt, comprehensive, and free healthcare delivered in hospitals appealed to patients and influenced their decision to bypass rural primary healthcare services. Strategies to reduce PPHs in rural Australian communities may include promoting health literacy, optimising the delivery of existing services, and improving social support structures.

Risk Factors Associated with Preventable Hospitalisation among Rural Community-Dwelling Patients: A Systematic Review

“…A further 26 papers were excluded for not meeting inclusion criteria, leaving 13 papers for review and analysis ( Figure 1 ). Eight papers were quantitative/descriptive studies [ 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ] and five were qualitative studies [ 40 , 41 , 42 , 43 , 44 ]. Only one study reported no statistically significant association between the variables studied (physician supply) and rural PPH risk [ 35 ].…”

“…The population for study was variably described; this included being conducted in administrative areas serviced by “rural Indian Health Services” [ 34 ] or rural “health professional shortage areas” in Nebraska [ 39 ]. Other studies described a specific rural region of Tasmania [ 36 , 40 , 41 ], Victoria [ 32 ], or New South Wales [ 37 , 42 , 43 , 44 ] as the setting. The remainder used large, usually national, datasets from which rural patient data could be extracted.…”

Identifying patterns of potentially preventable hospitalisations in people living with dementia

“…Therefore, to address PPHs in people with dementia, recent research has focused on assessing effectiveness of interventions by supporting carers to manage the health needs of the person with dementia [ 46 ]. In this context, it is also important to consider health literacy challenges faced by patients and their carers who often do not have a good understanding of where, when and how to manage their health [ 47 ]. At the same time, it is important to understand physicians’ views on PPHs, where previous studies have shown that many physicians hold the views that hospitalisations for ACSCs were unavoidable [ 41 , 48 ].…”

Specific Needs of Patients and Staff Reflected in the Design of an Orthopaedic and Rehabilitation Hospital—Design Recommendations Based on a Case Study (Poland)

“…If the expectations of the patients’ and medical staff’s quality of the environment is ensured, their comfort and well-being improve. In this area, architecture can play a significant role and predetermine the overall treatment process [ 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ].…”