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Table 7 Unique influence of context factors on increase/decrease in access arrangements and subsequent service level

From: Context matters for primary health care access: a multi-method comparative study of contextual influences on health service access arrangements across models of primary health care

Access dimension and example/s

Context factors and unique influence on access arrangements (increase ↑, decrease↓ service level)

Objectives of PHC model

Case size (small, medium, large)

Local workforce supply market conditions

Service stability (recent changes to structure, governance)

Location (ASGC)

Local population/patient profile identified need

IRSAD (local popn, or patient profile)

Relationship with LHN

Financial viability

Availability & accommodation

 Onsite AH i.e. after 6 pm weekdays; on weekends

Where explicit↑

Small↓

Shortage/oversupply of GPs↑,↓

Stable structure, governance and leadership may↑

Inner/Outer regional↑

Identified need↑

No clear association

No clear association

Focus on financial viability↑,↓

 Same day/walk-in GP appointments

Where explicit↑

No clear association

No clear association

No clear association

No clear association

No clear association

No clear association

No clear association

No clear association

Affordability

 Patient co-payments for non GP co-located services

Where explicit for vulnerable (including children) populations↑

No clear association

No clear association

No clear association

No clear association

Identified need↑

Ad hoc arrangement↑,↓

Strong presence of LHN services associated with ↑ in affordability

Focus on financial viability↑,↓

Acceptability

 Unique responses to acceptability to fit with context

Where explicit for vulnerable populations↑

No clear association

No clear association

Governance and leadership stability ↑

No clear association

Identified need↑

No clear association

No clear association

Focus on financial viability (sub-population opportunity) may↑

Appropriateness

 Co-location of allied health professionals (allied health)/medical specialists (med spec – priv/public)/Local hospital network (LHN) clinics

No clear association

No clear association

No clear association

No clear association

No clear association

No clear association

No clear association

Strong LHN relationship, referral network and communication↑

Focus on financial viability (via rental opportunity) may↑

Approachability

 Outreach programs (all provide some services in residential aged care settings and home visits)

Where explicit for vulnerable populations↑

No clear association

No clear association

No clear association

No clear association

Identified need↑

No clear association

No clear association

Focus on financial viability (sub-population opportunity) may↑