Primary Care Access Evaluation
Evaluating innovative primary care access models to understand their impact on access, health outcomes, patient and provider experience, system efficiency and health equity.
Community need
Healthy North Coast identified significant and persistent challenges in accessing timely primary care across the region. Analysis undertaken as part of the Primary Care Access initiative found that younger people, particularly those aged 15–24 years and more broadly those under 35 years, as well as Aboriginal and Torres Strait Islander people, were accessing hospital emergency departments for low-acuity care at rates above the national average. The Health Needs Assessment also identified barriers to accessing general practice, including appointment availability, affordability, geography and service accessibility, particularly in priority rural and regional communities.
Population growth, an ageing population and increasing demand for health services have amplified pressure on both primary care and hospital services across the North Coast. Healthy North Coast recognised that incremental improvements to existing models of care would be unlikely to deliver the transformational change required to improve access and reduce avoidable health system demand.
The Primary Care Access Evaluation was established to generate evidence about whether innovative primary care access models can improve access to care, reduce avoidable emergency department presentations, improve patient and provider experiences, strengthen health equity and deliver greater value for the health system. The evaluation supports continuous learning and informs future commissioning decisions, service redesign and sustainable approaches to improving primary care access across rural and regional communities.
Our approach
The Primary Care Access Evaluation uses a multi-year, mixed-methods evaluation approach to understand the implementation, outcomes and impact of the Primary Care Access initiative. The evaluation includes developmental, formative and summative stages, supported by annual planning, evaluation governance, data collection protocols and continuous quality improvement feedback cycles. It examines both process and outcome measures, including the four elements of the Quadruple Aim: patient experience, population health outcomes, cost-efficiency and provider experience.
The evaluation combines qualitative and quantitative methods, including service utilisation data, consumer and provider experience research, linked health system data analysis, economic analysis, theory of change development and ongoing insights reporting. This approach supports Healthy North Coast to understand not only whether the model improves access to primary care, but how, why and under what conditions it works. Findings are used to inform adaptive commissioning, service improvement, future investment decisions and the design of sustainable regional primary care access models.
Consultation
The Primary Care Access initiative and its evaluation were informed by an extensive co-design process involving consumers, healthcare providers, health system stakeholders and community representatives. The evaluation partner participated in co-design activities, contributed to outcomes mapping, and developed a theory of change, program logic and outcomes hierarchy to describe how improved primary care access was expected to be achieved.
The evaluation approach also includes stakeholder engagement, workshops, interviews and feedback processes to ensure that implementation learnings are captured and used to refine the model over time. Cultural safety and equity are key considerations, with the evaluation recognising the importance of Aboriginal and Torres Strait Islander governance, community-led approaches and culturally safe research methods. The evaluation has also identified the importance of explicitly co-designed strategies to address health disparities, particularly for Aboriginal and Torres Strait Islander communities and people living in areas of socioeconomic disadvantage
Key activities
Develop and maintain a multi-year evaluation framework for the Primary Care Access initiative, including developmental, formative and summative evaluation stages.
Develop evaluation plans, annual workplans, data collection protocols, outcome measures and reporting structures.
Establish and support evaluation governance arrangements, including consideration of Aboriginal and Torres Strait Islander cultural governance.
Develop and refine the program logic, theory of change and outcomes hierarchy for the Primary Care Access initiative.
Undertake qualitative and quantitative data collection, including consumer, provider and stakeholder experience research.
Analyse service utilisation, health system impact, access outcomes and patterns of care.
Undertake linked data analysis using health system datasets to assess emergency department, hospital and primary care utilisation.
Conduct economic analysis, including costs and consequences of the intervention.
Provide regular insights reports and feedback to support continuous quality improvement and adaptive commissioning.
Support the development of process and outcome measurement tools for commissioned services.
Produce evaluation reports, presentations, summaries, policy briefs and peer-reviewed publications where appropriate
Objectives
Evaluate the impact of the Primary Care Access initiative on access to primary care across the North Coast.
Assess whether the initiative contributes to reduced low-acuity emergency department presentations and improved use of primary care services.
Understand consumer, provider and stakeholder experiences of the model.
Assess whether the program improves care navigation, timely access and connection to appropriate services.
Evaluate outcomes against the Quadruple Aim: patient experience, population health, cost-efficiency and provider experience.
Examine whether the model improves access for priority populations, including young people, Aboriginal and Torres Strait Islander communities and people living in priority SA3 areas.
Identify implementation learnings to support ongoing service improvement and future commissioning decisions.
Build evidence about how regional primary care access models can be designed, adapted and sustained in rural and regional settings.
Generate learnings that can inform future models of care, policy development and investment in primary care access