title: A qualitative study of patient experiences of decentralized acute healthcare services.
abstract: OBJECTIVE
  Municipality acute wards (MAWs) have recently been launched in Norway as an alternative to hospitalizations, and are aimed at providing treatment for patients who otherwise would have been hospitalized. The objective of this study was to explore how patients normally admitted to hospitals perceived the quality and safety of treatment in MAWs.
  
  
  METHODS
  The study had a qualitative design. Thematic analysis was used to analyze the data.
  
  
  METHODS
  The study was conducted in a county in south-eastern Norway and included five different MAWs.
  
  
  METHODS
  Semi-structured interviews were conducted with 27 participants who had required acute health care and who had been discharged from the five MAWs.
  
  
  RESULTS
  Three subthemes were identified that related to the overarching theme of hospital-like standards ("almost a hospital, but…"), namely (a) treatment and competence, (b) location and physical environment, and (c) adequate time for care. Participants reported the treatment to be comparable to hospital care, but they also experienced limitations. Participants spoke positively about MAW personnel and the advantages of having a single patient room, a calm environment, and proximity to home.
  
  
  CONCLUSIONS
  Participants felt safe when treated at MAWs, even though they realized that the diagnostic services were not similar to that in hospitals. Geographical proximity, treatment facilities and time for care positively distinguished MAWs from hospitals, while the lack of diagnostic resources was stressed as a limitation. Key points   Municipality acute wards (MAWs) have been implemented across Norway. Research on patient perspectives on the decentralization of acute healthcare in MAWs is lacking.   • Patients perceive decentralized acute healthcare and treatment as being comparable to the quality they would have expected in hospitals.   • Geographical proximity, a home-like atmosphere and time for care were aspects stressed as positive features of the decentralized services.   • Lack of diagnostic resources was seen as a limitation.
authors: a Department of Research , Østfold Hospital Trust , Sarpsborg, Østfold , Norway ;|b Institute of Clinical Medicine , University of Oslo , Oslo , Norway ;
authors: Ann-Chatrin
authors: AC
authors: Linqvist Leonardsen
authors: c Faculty of Health and Social Studies , Østfold University College , Sarpsborg, Østfold , Norway ;
authors: Lilliana
authors: L
authors: Del Busso
authors: c Faculty of Health and Social Studies , Østfold University College , Sarpsborg, Østfold , Norway ;
authors: Vigdis
authors: V
authors: Abrahamsen Grøndahl
authors: a Department of Research , Østfold Hospital Trust , Sarpsborg, Østfold , Norway ;|b Institute of Clinical Medicine , University of Oslo , Oslo , Norway ;
authors: Waleed
authors: W
authors: Ghanima
authors: d Wayne University School of Medicine , Detriot, MI , USA.
authors: Paul
authors: P
authors: Barach
authors: a Department of Research , Østfold Hospital Trust , Sarpsborg, Østfold , Norway ;|c Faculty of Health and Social Studies , Østfold University College , Sarpsborg, Østfold , Norway ;
authors: Lars-Petter
authors: LP
authors: Jelsness-Jørgensen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D004632:Emergency Medical Services; D005260:Female; D006760:Hospitalization; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009664:Norway; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D011787:Quality of Health Care
keywords: Acute healthcare; Norway; decentralization; general practice; hospital-primary care interface; patient experiences; quality of care