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Investing in longitudinal studies of primary healthcare: what can we learn about service performance, sustainability and quality?

Primary health care (PHC) is recognised as an efficient, effective and equitable approach to health service delivery and successful PHC is integral to a sustainable and accountable healthcare system, and ultimately improved population health outcomes. Internationally there is a move towards strengthening and improving the quality of PHC. Nowhere is this more important than in rural and remote areas where, compared to metropolitan settings, there is poorer access to quality health care, and a disproportionate and preventable burden of morbidity and mortality. In light of the ongoing reviews of the Australian GP Super Clinic Programand Medicare Locals, it is timely to consider what we can learn about health service performance, sustainability and quality from a longitudinal study of a rural Australian PHC service. The Elmore Primary Health Service (EPHS) is a single-entry point private–public PHC model that provides services to its local and surrounding communities. The EPHS has been the focus of a longitudinal evaluation of its performance and sustainability for the past 6 years. Elmore is located 46 km north-east of Bendigo and 170 km north of Melbourne, the capital city of the state of Victoria, with a population of approximately 668. The current EPHS model was designed to meet local health needs following the closure of the town’s hospital 8 years earlier.