Transforming access, relational care, and primary health care in an urban Aboriginal and Torres Strait Islander population

Primary health care (PHC) systems throughout the world face the challenge of delivering quality care to growing populations with complex care needs. The Institute for Urban Indigenous Health (IUIH), a regional network of Aboriginal Community Controlled Health Services in South East Queensland has overseen substantial increase in uptake of care in their clients, with demonstrable improvement in health outcomes; however, evidence is emerging of the inability of the system to effectively respond to the rapid population growth, necessitating a redesign of the way care is delivered. This prospective observational cohort study using mixed-methods, will evaluate a model of patient centred medical homes, developed by an Alaskan Native controlled health service and adapted to the local context. Unique to this model is coordinated care that is delivered by a multidisciplinary team, rather than by individual clinicians.

This study is embedded in Aboriginal governance with internationally recognised research leads and will examine: the feasibility and acceptability of implementing the model of care; whether compared to pre-implementation, this model of care improves access and relational continuity of care; longer term health outcomes (such as hospitalisations and Aboriginal and Torres Strait Islander concepts of health); as well as cost-effectiveness.

The research findings will deliver key lessons for: (1) for broader PHC system reform, as well as for Aboriginal and Torres Strait Islander health, including relatedand distinct policy initiatives such as Health Care Homes; (3) system change management in real-world, PHC settings; and (4) Aboriginal led and governed models of research collaboration and distinct policy initiatives such as Health Care Homes; (3) system change management in real-world, PHC settings; and (4) Aboriginal led and governed models of research collaboration.