Role of general practitioner-led rural community hospitals in Sweden: a qualitative study

To explore rural general practitioners' (GPs') experiences of providing care in rural community hospitals (CHs) in northern Sweden.

An interview study, using qualitative content analysis.

The study was conducted in Norrbotten and Västerbotten counties in Sweden and included eight rural CHs.

Semi-structured interviews were conducted in 2018 with 15 rural GPs.

Two themes were identified: 'Being the hub in the patient's healthcare pathway' and 'Offering person-centred care far from hospital'. CHs are suitable for elderly, multimorbid and end-of-life patients, emphasising proximity, familiarity and discharge planning. They serve as primary care and intermediate hospital care hubs, collaborating with general hospitals and municipal caregivers. The rural GPs interviewed, as generalists, value holistic hospital patient care, and benefit from longitudinal patient knowledge. They highlighted these advantages and the cost-effectiveness of the CH model, arguing that it should be extended to urban regions. The rural GPs described their work situation as stimulating, but role conflicts in tight-knit communities, geographical distances and limited medical resources pose rural-specific ethical dilemmas.

Rural GPs value the holistic generalist perspective of CH care and emphasise the high-quality care that the CH setting enables them to provide. Despite rural-specific ethical dilemmas, they value the CH model and are concerned about its closures.