Patient Experience of Primary Care in One Small Hospital and One Non-Bedded Clinic in a Mountainous Rural Area of...

In Japan, both hospitals and outpatient clinics serve as primary care providers. However, the characteristics of primary care practices in hospitals and clinics, as well as the role and functions of primary care in mountainous and rural areas, are poorly understood. The purpose of this study was to identify the role and functions of primary care in small hospitals and outpatient clinics in mountainous areas, as well as the characteristics of primary care practices specific to these regions.

A descriptive study was conducted between January and March 2024 at two municipal facilities in western Tottori Prefecture: Hino Hospital and Ebi Clinic. Adult patients who had received care in general medicine or general practice for more than six months were invited to complete the Japanese version of the Primary Care Assessment Tool (JPCAT).

Valid responses were obtained from 254 patients at Hino Hospital and 27 at Ebi Clinic, with response rates of 90.6% and 100%, respectively. First Contact scores were higher at Hino Hospital, while Community Orientation scores were higher at Ebi Clinic. Other domain scores showed broadly similar ranges.

Differences in patterns of First Contact and Community Orientation were observed across the two facilities. These findings describe how primary care is perceived within a shared rural context and should not be interpreted as causal or generalizable differences between facility types.