title: "Beyond workforce": a systemic solution for health service provision in small rural and remote communities.
abstract: Successful, "innovative" primary health care (PHC) models exist that have adapted to the specific circumstances of their rural and remote context. A typology of discrete, integrated, comprehensive and outreach rural and remote services exists rather than a "one coat fits all" PHC health service model. Successful models are characterised by macro-scale environmental enablers (supportive health policy, federal-state relations, and community readiness) and five essential service requirements (workforce organisation and supply; funding; governance, management and leadership; linkages; and infrastructure). Service sustainability depends on ensuring that key systemic service requirements are met at the local level in ways that accord with, and are supported by, the broader macro-scale environmental enablers. Based on these principles, these model types are amenable to generalisation and evaluation in other regions.
authors.affiliation: School of Rural Health, Monash University, Bendigo, VIC, Australia. john.humphreys@med.monash.edu.au
authors.forename: John S
authors.initials: JS
authors.lastname: Humphreys
authors.forename: John
authors.initials: J
authors.lastname: Wakerman
authors.forename: Robert
authors.initials: R
authors.lastname: Wells
authors.forename: Pim
authors.initials: P
authors.lastname: Kuipers
authors.forename: Judith A
authors.initials: JA
authors.lastname: Jones
authors.forename: Phil
authors.initials: P
authors.lastname: Entwistle
mesh_terms: D001315:Australia; D003695:Delivery of Health Care; D006291:Health Policy; D017146:Models, Organizational; D011320:Primary Health Care; D019035:Rural Health Services