In-Between Policy Vision and Practical Realities of Primary Healthcare: A Case Study in Rural Northern Sweden

Area of Science:

• Health Services Research
• Rural Health Policy
• Primary Care Innovation

Background:

• Sweden's "Good Quality and Local Health Care" reform aims to center primary care (PC) with interorganizational collaboration and e-Health.
• Rural areas face unique challenges in implementing national health policies due to resource constraints and urban-centric perspectives.

Purpose of the Study:

• To explore how rural primary care actors in a sparsely populated Swedish region navigate the national primary healthcare vision.
• To identify challenges and successes in implementing the reform in a rural context.

Main Methods:

• A single case study design was employed in a rural municipality in northern Sweden.
• Thematic analysis was conducted on data from interviews and observations.

Main Results:

• National policies showed suboptimal alignment with the rural municipality's needs.
• Existing local collaborations predated the reform, leading to understaffing for both networks and reform efforts.
• Scaling up e-Health technology faced impediments, despite existing practices of person-centered and integrated care being insufficiently recognized.

Conclusions:

• Rural proofing is crucial for scrutinizing national health policy-making to ensure alignment with local needs.
• The study highlights misalignments between national health policy visions and rural realities, emphasizing the need for greater inclusion of rural perspectives in policy development.