{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T03:26:28Z","timestamp":1765423588372,"version":"3.41.2"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,5,18]],"date-time":"2025-05-18T00:00:00Z","timestamp":1747526400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017511","name":"Metro North Hospital and Health Service","doi-asserted-by":"publisher","award":["LINK 213"],"award-info":[{"award-number":["LINK 213"]}],"id":[{"id":"10.13039\/100017511","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Australian J Rural Health"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate a Hub\u2010and\u2010Spoke design for providing sleep disorder services in a very remote community. The health service re\u2010design aimed to provide unattended polysomnography at the Spoke site with access to attended laboratory studies at the Hub when clinically indicated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Summative evaluation using the RE\u2010AIM Framework including all adult patients referred for diagnosis and management of a suspected sleep disorder from Remote Health Service to Metropolitan Health Service 2\u2009years pre\u2010implementation and 1\u2009year post\u2010implementation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Controlled before\u2010and\u2010after implementation outcome study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Public hospital in metropolitan South\u2010East Queensland with a comprehensive accredited sleep disorder service (Hub), networked to a Community Health Centre (Spoke), located in a very remote region defined by the Modified Monash Model in central Queensland.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcomes Measures<\/jats:title><jats:p>Referral numbers (Reach), travel avoidance and consumer satisfaction (Effectiveness), number of referrers (Adoption), unattended sleep study data quality, timeliness to testing, health service costs (Implementation), and referral numbers beyond initial 12\u2010month pilot (Maintenance).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The Hub\u2010and\u2010Spoke model increased adoption five\u2010fold by local referrers and resulted in a nine\u2010fold increase in reach. Effectiveness was demonstrated through high levels of consumer satisfaction, and all implementation aims were met, including providing services at a lower cost. Sustainability was demonstrated through ongoing referrals and the transition of the model of care to business as usual.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Hub\u2010and\u2010Spoke designs for public sleep disorder services are effective at both the individual and organisational levels. Services can be delivered at a lower cost and, importantly, improve access to specialist services in remote and very remote communities.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajr.70057","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T06:54:42Z","timestamp":1747637682000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of a Hub\u2010And\u2010Spoke Model of Care for the Delivery of Sleep Disorder Services to a Remote Australian Community Using the <scp>RE<\/scp>\u2010<scp>AIM<\/scp> Framework: A Controlled Before\u2010And\u2010After Implementation Outcome Study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6989-3475","authenticated-orcid":false,"given":"Irene","family":"Szollosi","sequence":"first","affiliation":[{"name":"Sleep Disorders Centre The Prince Charles Hospital  Queensland Australia"},{"name":"School of Biomedical Sciences, Faculty of Medicine The University of Queensland  Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophia","family":"Worley","sequence":"additional","affiliation":[{"name":"Sleep Disorders Centre The Prince Charles Hospital  Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameera","family":"Senanayake","sequence":"additional","affiliation":[{"name":"Health Services and Systems Research Duke\u2010NUS Medical School  Singapore"},{"name":"Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health Queensland University of Technology  Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjeewa","family":"Kularatna","sequence":"additional","affiliation":[{"name":"Health Services and Systems Research Duke\u2010NUS Medical School  Singapore"},{"name":"Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health Queensland University of Technology  Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deanne","family":"Curtin","sequence":"additional","affiliation":[{"name":"Sleep Disorders Centre The Prince Charles Hospital  Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,18]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(23)00182-2"},{"key":"e_1_2_11_3_1","unstructured":"Sleep Health Foundation \u201cRise and Rry to Shine: The Social and Economic Cost of Sleep Disorders in Australia \u201d 2021. 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