Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia.
School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia.
Aust J Rural Health. 2023 Dec;31(6):1050-1059. doi: 10.1111/ajr.13003. Epub 2023 Jun 4.
Young people in rural Australia have limited access to health care and are at increased risk of poor health outcomes. The Teen Clinic model was developed to increase access to health care for young people, particularly school-aged young people (12-18 years) living in small rural towns (<5000 people).
To determine the extent the Teen Clinic model meets its accessibility objective and to determine the barriers and enablers to sustainable delivery of the Teen Clinic service.
A multimethod case study approach was used to assess access (multidimensional framework for patient-centred access) and determine the barriers and enablers to sustainable delivery. Data collection included a survey of young people in the included rural communities and key stakeholder interviews.
The survey of young people indicated Teen Clinic model was accessible across multiple dimensions. From a practice perspective, accessibility was achieved by varying from usual care to a nurse-led, young person-centred drop-in model. This required skilled nurses working at the top of their scope; however, unpredictable demand and patient complexity made accounting for the time and therefore funding somewhat complex.
The Teen Clinic model meets its objective of increasing healthcare access for young rural people. Relational and cultural factors were more important facilitators of practice integration than organisational processes. A key challenge to the ongoing provision of Teen Clinic was dedicated sustainable funding.
Teen Clinic is an integrated primary healthcare model that increases access for young people in small rural communities. Sustainable implementation would benefit from dedicated funding.
澳大利亚农村地区的年轻人获得医疗保健的机会有限，健康状况不佳的风险增加。青少年诊所模式旨在增加年轻人（12-18 岁）获得医疗保健的机会，尤其是居住在小农村镇（<5000 人）的青少年。
确定青少年诊所模式在多大程度上实现了其可及性目标，并确定可持续提供青少年诊所服务的障碍和促成因素。
采用多方法案例研究方法评估可及性（以患者为中心的可及性多维框架）并确定可持续提供服务的障碍和促成因素。数据收集包括对纳入农村社区的年轻人进行调查和对主要利益相关者进行访谈。
对年轻人的调查表明，青少年诊所模式在多个方面都具有可及性。从实践的角度来看，通过从常规护理转变为以护士为主导、以年轻人为中心的即到即诊模式，实现了可及性。这需要技能熟练的护士在其能力范围内工作；然而，不可预测的需求和患者的复杂性使得时间和因此的资金核算有些复杂。
青少年诊所模式实现了为农村年轻人增加医疗保健可及性的目标。关系和文化因素比组织流程更能促进实践的整合。青少年诊所持续提供的一个主要挑战是需要有专门的可持续资金。
青少年诊所是一种综合的初级保健模式，增加了小型农村社区年轻人的可及性。可持续实施将受益于专门的资金。
