Rural Stories of Getting Back Home: An integrated knowledge translation study of people’s experiences of navigating access to healthcare from rural and remote communities in British Columbia, Canada

• Published in: International Journal of Integrated Care
• Main Authors: Oelke, Nelly, Plamondon, Katrina, Kornelsen, Jude
• Format: Article in Journal/Newspaper
• Language: English
• Published: Ubiquity Press 2021
• Subjects: First Nations
• Online Access: https://account.ijic.org/index.php/up-j-ijic/article/view/5877; https://doi.org/10.5334/ijic.s4106

IntroductionIn British Columbia (BC), Canada, health systems centralization shifted services to population-dense cities within geo-politically defined geographies. Although intended to create structures to respond more efficiently to local needs, the result has been a reduction in rural and remote services. People living in rural and remote communities face disproportionate socioeconomic burdens related to navigating health care. With growing interest in providing care closer to home, rural communities face particular challenges. In BC’s interior, one healthcare organization serves more than 100 rural and remote communities, including 54 First Nations communities, across 250,000 km2. People travel vast distances, crossing multiple mountain passes through year-round intense weather to access care.Methods/TheoryOur research question was: What are the experiences of patients, their families, and nursing care providers in transitions from a referral centre back to rural communities? This integrated knowledge translation study used narrative methods to document stories of people living in rural communities who were referred for care, but chose not to go. Our research team included patient and community voices, decision makers (i.e., administrative leaders), clinicians, students, and researchers—actively doing research with people who could affect change in response to the experiences of people living in rural communities.ResultsFindings highlighted the complexity of fragmentation within healthcare and transportation systems that interact with increasingly complex patient needs. Patients and families experienced emotional and financial hardship related to trying to get back home. Discharge planning and transportation coordination were frequently challenging for patients, their families, and their care providers—with limited participation of patients and families in the process overall.DiscussionEmbedded in the realities of living rurally and accessing healthcare are multiple assumptions. These assumptions occur at ...