Evaluating allied health primary contact models of care: A mixed methods analysis of current practice

Rationale: Allied Health Primary Contact Clinic (AHPCC) models of care are increasingly used to manage growing demands on health service capacity. There is a critical need for new models of care to demonstrate value, however comprehensive evaluation of AHPCCs, including use of metrics frameworks like the Moretto framework, have been slow to uptake, and the reasons for this are unclear.

Aims and objectives: To understand current evaluation practices as mapped to the Moretto framework, and explore clinician attitudes to the process of service evaluation across a variety of AHPCC models implemented within a metropolitan health service in Queensland, Australia.

Method: A convergent mixed methods approach was used. Data were collected in 2022 using a quantitative presurvey, followed by a qualitative descriptive interview with AHPCC lead clinicians. Thirty AHPCCs were eligible, and all potential participants who provided consent were included. Descriptive statistics and thematic analysis were used for quantitative and qualitative data respectively, then merged and reported jointly.

Results: Twenty-three clinicians representing 22 different AHPCCs participated. AHPCC models were found to be complex and varied. Evaluation practices were variable across AHPCCs, although more than half collected most of the Moretto framework measures. Quality of life and resource use measures were least commonly collected. Themes regarding participants' experience of AHPCCs evaluation were that: Evaluation is complex and challenging; Evaluation is important; and Evaluation needs to be enabled.

Conclusion: For health services to fully understand the value of their AHPCC services and direct their limited resources appropriately, evaluation activity needs to be better valued and enabled at a local, statewide and national level. Strategies should include protected time, funding, administrative support, leadership support, access to mentorship, development of structures which enable collaborative evaluation at a state-wide (or broader) level, and a shared understanding of value and core areas for measurement across stakeholders.