Exploring the response to the COVID-19 pandemic at the rural hospital–base hospital interface: experiences of New Zealand rural hospital doctors

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Just in case you missed the highlight in today’s NZMJ!

Exploring the response to the COVID-19 pandemic at the rural hospital–base hospital interface: experiences of New Zealand rural hospital doctors

Garry Nixon, Katharina Blattner, Stephen Withington, Rory Miller, Tim Stokes. NZMJ 12 November 2021, Vol 134 No 1545

The study found that during the first L4 lock-down that communication and processes linking rural hosptials to base hospitals were disrupted. DHB support for rural hosptials varied widely and an established local leadership facilitiated an effective local response. Equity concerns persist regarding transfer, especially those who are critically unwell.

The paper is open access and can be found at:


Along with a couple of media interviews!






The COVID-19 pandemic stress-tested health systems globally and accentuated pre-existing health inequities. There is little understanding of the impact that the 2020 pandemic preparations had on New Zealand’s rural hospitals. This study explores rural hospital doctors’ experiences of the COVID-19 pandemic, with an emphasis on the rural hospital–base hospital interface.


Seventeen semi-structured interviews were conducted with rural hospital doctors across New Zealand. A thematic analysis using a framework-guided rapid analysis method was undertaken.


The regular communication channels and processes linking rural hospitals to their urban base hospitals were disrupted as the pandemic began. Established local leadership facilitated a rural hospital’s ability to make an effective local response. District health board (DHB) support for their rural hospitals varied widely and largely reflected the status of the pre-pandemic relationship. DHB understanding of rural hospital facilities and processes was considered to be poor. Ongoing uncertainty around managing and transferring acutely unwell patients with COVID-19 remained. Equity concerns centred on access to advanced care.


The experience of the COVID-19 pandemic has highlighted the resilience of rural hospitals as well as the challenges they face in operating at the margins of the healthcare system.



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