title: Dunedin's free clinic: an exploration of its model of care using case study methodology.
abstract: BACKGROUND
  Models of care are important therapeutic modalities for achieving the goals of health care teams, but they are seldom explicitly stated or investigated.
  
  
  OBJECTIVE
  To describe the model of care at Dunedin's free clinic, and assess whether this model catered to the particular needs of enrolled patients.
  
  
  METHODS
  A mixed methods study was conducted using case study methodology to construct the clinic's model of care from multiple data sources, and to create a profile of patients' needs. A nested case study of patients with diabetes examined patients' social vulnerability characteristics. The pattern matching analytic technique was used to assess the degree of alignment between the model of care and patients' needs.
  
  
  RESULTS
  Patients were not only high users of both primary and secondary health care, but also of justice and social welfare sector services. The care of patients with diabetes was complicated by coexisting social vulnerability and medical comorbidities. Surveyed patients placed high value on interpersonal dimensions of care, the Christian ethos of the clinic, and the wider range of services available.
  
  
  CONCLUSIONS
  This study suggests a degree of 'fit' between the clinic's model of care and the needs of enrolled patients. A model of care that caters to the needs of patients with complex needs is important for securing their engagement in health services.
authors.affiliation: Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. lik_wei@mac.com.
authors.forename: Lik
authors.initials: L
authors.lastname: Loh
authors.affiliation: Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Chrystal
authors.initials: C
authors.lastname: Jaye
authors.affiliation: Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Susan
authors.initials: S
authors.lastname: Dovey
authors.affiliation: Best Practice Advocacy Centre Inc (BPAC Inc), Dunedin, New Zealand.
authors.forename: Hywel
authors.initials: H
authors.lastname: Lloyd
authors.affiliation: Formerly Dunedin's free clinic, Dunedin, New Zealand.
authors.forename: Joanne
authors.initials: J
authors.lastname: Rowe
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000191:economics*; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D009520:New Zealand; D019982:Organizational Case Studies; D011320:Primary Health Care; D036301:Qualitative Research; D035862:Vulnerable Populations