How do small rural primary health care services sustain themselves in a constantly changing health system environment?
Open accessAbstract
BACKGROUND: The ability to sustain comprehensive primary health care (PHC) services in the face of change is crucial to the health of rural communities. This paper illustrates how one service has proactively managed change to remain sustainable. METHODS: A 6-year longitudinal evaluation of the Elmore Primary Health Service (EPHS) located in rural Victoria, Australia, is currently underway, examining the performance, quality and sustainability of the service. Threats to, and enablers of, sustainability have been identified from evaluation data (audit of service indicators, community surveys, key stakeholder interviews and focus groups) and our own observations. These are mapped against an overarching framework of service sustainability requirements: workforce organisation and supply; funding; governance, management and leadership; service linkages; and infrastructure. RESULTS: Four years into the evaluation, the evidence indicates EPHS has responded effectively to external and internal changes to ensure viability. The specific steps taken by the service to address risks and capitalise on opportunities are identified. CONCLUSIONS: This evaluation highlights lessons for health service providers, policymakers, consumers and researchers about the importance of ongoing monitoring of sentinel service indicators; being attentive to changes that have an impact on sustainability; maintaining community involvement; and succession planning.
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Our experiences collaborating with rural primary healthcare teams to develop and implement the memory clinics highlighted the complex nature of the rural healthcare context and are consistent with the view of innovation as an unpredictable journey and a process of managing and supporting continuous improvement and adaptation.
“Our experiences in collaborating with rural PHC teams to develop and implement the memory clinics have highlighted the complex nature of the rural healthcare context [51] and are consistent with the view of innovation as an unpredictable journey, and a process of managing and supporting continuous improvement and adaptation [40].”
From Factors influencing sustainability and scale-up of rural primary healthcare memory clinics: perspectives of clinic team members (2022) · cites this paper as [51]
Organizational and leadership support are important for sustaining small rural primary healthcare services and programs in low-resource contexts.
“Organizational and leadership support have been identified as important for sustaining small rural PHC services [51] and programs in low-resource contexts [47] and were particularly relevant to implementing this team-based intervention in a rural setting.”
From Factors influencing sustainability and scale-up of rural primary healthcare memory clinics: perspectives of clinic team members (2022) · cites this paper as [51]
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- Authors
- Buykx, P., Humphreys, J. S., Tham, R., Kinsman, L., Wakerman, J., Asaid, A., & Tuohey, K.
- Affiliations
- Monash University (AU)
- Bendigo Health (AU)
- Flinders University (AU)
- Corresponding author
- Buykx, Penny
- Venue
- BMC Health Services Research
- Published
- 2012-03-26
- Volume
- 12
- Issue
- 1
- Pages
- 81-81
- ISSN
- 1472-6963 (ISSN-L)
- PMC
- PMC3342227
- OpenAlex
- W2096123402
- Cited by
- 38
- References
- 16
- Citations by year
- 2026: 2 · 2024: 1 · 2023: 3 · 2022: 5 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 1 · 2017: 3 · 2016: 2 · 2015: 5 · 2014: 8 · 2013: 1
- FWCI
- 7.96
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Health Services Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Figshare (submittedVersion, cc-by)
- eCite Digital Repository (University of Tasmania) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Funders
- Australian Government
- Australian Rotary Health
- Australian Primary Health Care Research Institute, Australian National University
- Topics
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Health Professions › Emergency Medical Services › Global Health Workforce Issues
- Health Sciences › Health Professions › General Health Professions › Healthcare Systems and Practices
- Keywords
- rural health care, comprehensive primary health care, health system transformation, health care financing, health service governance, community participation, succession planning
- MeSH terms
- Workforce, Community-Institutional Relations, Comprehensive Health Care, Humans, Leadership, Longitudinal Studies, National Health Programs, Organizational Innovation, Organizational Objectives, Primary Health Care, Quality Assurance, Health Care, Victoria, Models, Organizational, Efficiency, Organizational, Delivery of Health Care, Integrated, Rural Health Services, Narration, Capacity Building
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