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These four models are further explicated in Table 2.17.

Table 2.17 Typology of ‘Innovative’ Remote and Rural Models of Healthcare (Source: Humphreys & Wakerman, 2008, p. 6)

Context: Rural-remote continuum RURAL Larger, more closely settled communities

PHC Model and Examples

Main Drivers Underpinning Model

Discrete Services ‘Walk-in/walk-out’ model Viable models of General Practice University clinics Integrated Services Shared care Co-ordinated care trials PHC teams Multi-purpose services Comprehensive PHC Services Aboriginal Controlled Community Health Services

Population numbers are usually sufficient to meet essential service requirements (although some supports are still needed to address workforce recruitment and retention). Service integration resulting from pooled funding maximises efficiencies and access to locally available services. Single point-of-entry to the health system helps to co-ordinate patient care and reduces the need for travel. Community participation, service flexibility to meet local circumstances, and access to services are critical components where few alternative ways of delivering appropriate care exist. Periodic outreach services (sometimes co-existing with other models) provide care to communities too small to support permanent local services.

Outreach Services ‘Hub-and-spoke’ models Visiting services ‘Fly-in, fly-out’ services Telehealth/telemedicine

REMOTE Small populations dispersed over vast areas

The most common of the four models in remote Australia is outreach services, which is comprised of four sub-classifications. The ‘hub-and-spoke’ (Battye & McTaggart,