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  • Features of effective primary health care models in rural and remote Australia: a case study analysis

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    Author(s)
    Wakerman, John
    Humphreys, John S
    Wells, Robert
    Kuipers, Pim
    Jones, Judith A
    Entwistle, Philip
    Kinsman, Leigh
    Griffith University Author(s)
    Kuipers, Pim
    Year published
    2009
    Metadata
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    Abstract
    Objective: To describe the factors and processes that facilitate or inhibit implementation, sustainability and generalisation of effective models of primary health care (PHC) service delivery in rural and remote Australia. Design: Case-study approach, including review of relevant literature, interviews with key informants, site visits and direct observation. Thematic analysis and template analysis were used with interview transcripts. An expert reference group provided feedback and advice on policy relevance. Setting and participants: Six PHC services in small communities across rural and remote Australia were selected ...
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    Objective: To describe the factors and processes that facilitate or inhibit implementation, sustainability and generalisation of effective models of primary health care (PHC) service delivery in rural and remote Australia. Design: Case-study approach, including review of relevant literature, interviews with key informants, site visits and direct observation. Thematic analysis and template analysis were used with interview transcripts. An expert reference group provided feedback and advice on policy relevance. Setting and participants: Six PHC services in small communities across rural and remote Australia were selected based on results of a previous systematic review; they reflected diverse rural and remote settings and PHC models, and the multidisciplinary nature of PHC. Sites were visited, and 55 individuals associated with the establishment and operation of these services were interviewed between July 2006 and December 2007. Results: Independent and template analysis confirmed the usefulness of a conceptual framework, which identified three key "environmental enablers" - supportive policy; federal and state/territory relations; and community readiness - and five essential service requirements - governance, management and leadership; funding; linkages; infrastructure; and workforce supply. Systematically addressing each of these factors improves effectiveness and lessens the threat to service sustainability. Conclusions: Evidence from existing effective rural and remote PHC services can inform the health care reform agenda, in Australia and other countries. The evidence highlights the need for improved governance, management and community involvement, as well as strong, visionary political leadership to achieve a more responsive and better coordinated health system which could help eliminate existing health status differentials between cities and rural areas. In Australia, establishment of a single national health system, operationalised at a regional level, would obviate much of the current inefficiency and poor coordination.
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    Journal Title
    Medical Journal of Australia
    Volume
    191
    Issue
    2
    Publisher URI
    https://www.mja.com.au/journal/2009/191/2/features-effective-primary-health-care-models-rural-and-remote-australia-case
    Copyright Statement
    Wakerman J, Humphreys JS, Wells R, et al. Features of effective primary health care models in rural and remote Australia: a case-study analysis. Med J Aust 2009; 191 (2): 88-91. © Copyright 2009 The Medical Journal of Australia – reproduced with permission.
    Subject
    Biomedical and clinical sciences
    Primary health care
    Psychology
    Publication URI
    http://hdl.handle.net/10072/40110
    Collection
    • Journal articles

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