Qualitative research for a study of the structural factors behind declining essential medical care
Project overview
The project conducted qualitative research with experts in emergency care, cardiovascular and cerebrovascular care, maternal and childbirth care, and pediatric and adolescent care. It examined clinical conditions, regional gaps in access and structural factors affecting essential-care capacity.
Main activities
- Expert consultation across four fields: emergency care, cardiovascular and cerebrovascular care, maternal and delivery care, and pediatrics
- Exploration of changing care conditions, workforce and institutional factors, working environments, and patient service use
- Organization of issues concerning regional access disparities, locally complete care, and patient transfers and referrals
- Cross-field comparison of common and differing perspectives to inform discussion of institutional and operational improvements
Research and methods
The study covered four fields: emergency care, cardiovascular and cerebrovascular care, maternal and delivery care, and pediatrics. Data collection took place in July and August 2026 through four online focus group interviews, four preliminary interviews, and five written responses. There were 19 unique participants. The overall project period ran from July to October 2026.
Purposive sampling considered professional expertise, metropolitan and non-metropolitan locations, institution type, and the roles of regional and local centers. The study explored care conditions, staffing, institutions, working environments, patient service use, regional disparities, and transfer and referral experiences.
Analysis combined deductive categorization using predefined themes with inductive conceptualization to identify concepts in participants’ accounts. Qualitative content analysis organized 610 meaning units and compared shared and differing issues across the four fields.
The findings were organized as background for discussions on sustaining essential care functions and improving institutional and operational arrangements. The analysis centered on expert experiences and perceptions, distinguishing changes in service volume from operational care capacity and examining similarities and differences across fields.
The project supported related research at the Health Insurance Research Institute. It was commissioned by Gachi Solution, with Dongyang University’s Industry–Academic Cooperation Foundation as the contracting research organization.