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 | |||