Rural citizen-patient priorities for healthcare in British Columbia, Canada: findings from a mixed methods study

Jude Kornelsen,Christine Carthew,Catherine Bodroghy,Delia Roberts,Kayla Míguez,Kathryn Petrunia,Matilda Taylor

doi:10.1186/s12913-021-06933-z

Abstract

BackgroundThe 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.MethodsWe 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.ResultsWe 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.ConclusionsTwo 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.

Highlights

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
British Columbia (BC)’s Regional Health Authorities have responsibilities to engage citizens-patients to plan and deliver health services that satisfy population needs in their respective regions [4]
The online survey was hosted on the University of British Columbia Survey Tool, provided by Qualtrics

Summary

Introduction

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. There has been recognition of the importance of a broad coalition of key stakeholders in healthcare decision-making and the attendant move from an administratively-oriented process to one that prioritizes diversity of voices. Broad-spread recognition of the importance of healthcare users’ input has gained so much traction that many jurisdictions have instituted mechanisms to facilitate such involvement from an individual committee level (e.g., British Columbia Patients as Partners1) [1] to a systemic level through prioritized patient-oriented research [2]. In British Columbia (BC), Canada, citizen-patient participation in healthcare decision-making, planning and research takes many forms and occurs at varying levels (locally, regionally, provincially). Engagement opportunities are unique to each Health Authority and might involve focus groups, surveys and workshops, presentations to municipal councils and community organizations, and participation on advisory committees

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