Table 2

Typology of rural and remote PHC models

CATEGORY

HEALTH SERVICE MODELS

RATIONALE/SENTINEL ISSUE

MEASURES OF SUCCESS


Discrete Services

• 'Walk-in/Walk-out' (20)

Sustainable medical workforce(getting GPs into rural services)

• Increased number of doctors recruited (20)

• Viable models/sustainable models (19, 21)

• University clinics (17, 18)


Integrated Services

• Shared care (23, 24)

Coordination between and access to services otherwise not available locally or not sufficient

• Decreased suicide rate; decreased GP isolation & increased confidence (23, 24)

• Co-ordinated Care Trials (CCTs – mainstream) (25)

• PHC teams (multidisciplinary)

(26–28)

• Decreased waiting times, reduced after hours call-outs; enhanced continuity of care; reduced inappropriate ED attendance (26)

• Multi-Purpose Services Program (29–32)

• Increased service access; reduced residential care; increased home-based services (29–31)


Comprehensive PHC Services

• Aboriginal Controlled Community Health Services (including Aboriginal CCTs) (33–35, 36–38)

Primary focus on improved access to services

• Some improved processes of care (32); increased community participation (34); enhanced funding, improved community participation, improved governance, increased staff numbers, increased utilisation, new population health programs (37, 38)


Outreach Services

• Hub-and-spoke (40, 41)

Access to service for communities too small to support discrete rural service. A secondary driver relates to sustainable workforce

• Increased occasions of service; increased workforce length of stay; increased referrals; improved cost-effectiveness (41)

• Visiting/periodic services (42, 43)

• Fly-in, fly-out


Virtual Outreach Services (IT/Telehealth)

• Virtual amalgamation (44, 45)

Use of IT to increase access to and sustain service for communities too small to support discrete rural service

• Improved access to records; reduced GP on call; increased consultation hours (44)

• Virtual clinics – video pharmacy/assessment & monitoring

• Tele-health/-medicine


Wakerman et al. BMC Health Services Research 2008 8:276   doi:10.1186/1472-6963-8-276

Open Data