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Annual Report - Performance Indicators
Outcome Performance ReportMajor AchievementsOutcome SummaryPerformance IndicatorsFinancial Resources Summary


PERFORMANCE INDICATORS (EFFECTIVENESS INDICATORS)


The Department of Health and Ageing is responsible, and accountable, for contributing to the achievement of nine outcomes. Effectiveness indicators are used to measure the progress the Department is making in achieving our outcomes.

Listed below are the effectiveness indicators for Outcome 6 followed by a brief description of the Department’s performance in meeting these targets.

Indicator 1. Client usage of Australian Government funded hearing devices

Target:

Improve the level of hearing device usage.

Information source/reporting frequency:

Annual survey data - Office of Hearing Services Client Survey.


Data collected through the 2004-05 Office of Hearing Services Survey indicated that 35 per cent of active voucher clients (including both new and return clients) used their hearing device for more than eight hours per day, while 31 per cent used their device for five to eight hours per day. According to the survey, 27 per cent of active voucher clients used their device for one to four hours per day, and 5 per cent for less than one hour per day.

Comparisons with the results of the previous surveys are not valid, as a new and expanded sampling methodology was introduced in 2004-05.

Indicator 2. Up-take of hearing rehabilitation services in the community

Target:

Vouchers provided to meet demand from eligible clients.

Information source/reporting frequency:

Annual departmental and Australian Bureau of Statistics data.


The Office issued 192,161 vouchers to new and return clients in 2004-05, an increase of 8 per cent over the previous year, during which 178,413 vouchers were issued. All clients who submitted a completed voucher application form and met the relevant eligibility criteria were issued with a voucher.

Indicator 3. Contracted hearing service providers provide eligible clients with quality hearing services, consistent with Clinical Standards and Rules of Conduct

Target:

Contracted service providers comply with the Clinical Standards and Rules of Conduct prescribed in service provider contracts.

Information source/reporting frequency:

Ongoing departmental information systems and audits.


The Office reviewed the client files of 203 practitioners employed by contracted service providers, as part of its quality assurance program. These practitioners represent 23 per cent of the total number of audiologists and audiometrists as at 30 June 2005. Audits were undertaken of 16 sites and 17 new providers to ensure compliance with the Clinical Standards and Rules of Conduct. An additional 17 practitioners were audited to assess their adherence to the Refitting Guidelines. The majority of service providers, and their employees, complied with the prescribed standards and requirements.

The Office took action against three service providers in response to breaches of either the contractual requirements or conditions of accreditation.

The system of distributing Service Provider Advice notices was improved and formalised in February 2005. A total of 12 notices were distributed under the new system. As well as informing providers of developments and changes in the administration of the Program, the notices reiterated key contractual requirements and standards for the delivery of hearing services.

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Indicator 4. The proportion of eligible Aboriginal and Torres Strait Islander clients receiving hearing assistance under the Program in relation to the total volume of program clients

Target:

Improve the level of Aboriginal and Torres Strait Islander peoples receiving hearing assistance as a proportion of the total number of program clients.

Information source/reporting frequency:

Quarterly Office of Hearing Services and Australian Hearing databases.


3,221 Aboriginal and Torres Strait Islander persons accessed hearing services through Australian Hearing in 2004-05, an increase of 31 per cent over the previous year. These clients accessed services through the Australian Hearing Specialist Program for Indigenous Australians outreach program which is managed and delivered by Australian Hearing.

Aboriginal and Torres Strait Islander people comprised 9 per cent of all special needs clients receiving hearing services during 2004-05, an improvement over the previous year (7 per cent).

While eligible Aboriginal and Torres Strait Islander people are able to access hearing services under the voucher system, they are not required to identify themselves as being of Aboriginal and/or Torres Strait Islander descent. Accurate data on the number of these clients is therefore not available.

The number of clients accessing the Program who voluntarily identified as Aboriginal and/or Torres Strait Islander comprised 0.8 per cent of the total number of active clients under the Program (including both special needs and voucher clients). This is, however, likely to be an underestimation as it would not account for all Aboriginal and Torres Strait Islander voucher clients.

Indicator 5. The proportion of eligible clients with complex needs and Australians under 21 receiving hearing assistance under the Program in relation to the total volume of program clients

Target:

Maintain the level of other special needs groups receiving hearing assistance as a proportion of the total number of program clients.

Information source/reporting frequency:

Quarterly Office of Hearing Services and Australian Hearing databases.


A total of 36,407 clients with special needs accessed hearing services during 2004-05, comprising 8 per cent of the total number of active clients under the Program (including both special needs and voucher clients). This is consistent with the previous year, where clients with special needs also comprised 8 per cent of the total number of active clients under the Program.

Breakdowns of specific special needs groups are provided below:
  • 5.5 per cent of the total number of clients who accessed the Program were children and young adults under 21 years of age (compared to 6 per cent of total Program clients in the previous year);
  • 0.4 per cent of the total number of clients who accessed the Program reside in remote localities (previously 0.4 per cent); and
  • 3 per cent of total Program clients were identified as adults with complex needs (previously 3 per cent).
Note that some clients would be included in more than one of the above categories, for example, adults with complex needs who also reside in remote localities.

Indicator 6. Research that contributes to improved rehabilitation outcomes for hearing impaired people and to community health is relevant and available

Target:

All research results are relevant and available to the community, service providers and manufacturers of hearing products.

Information source/reporting frequency:

Annual feedback from hearing service delivery, hearing device manufacturing industry, hearing impaired clients and overseas.


The National Acoustics Laboratory (NAL), the research arm of Australian Hearing, undertook research funded by the Department in the following broad areas:
  • assessment of hearing loss;
  • prevention of hearing loss;
  • hearing aids and rehabilitation devices; and
  • rehabilitation procedures.
The NAL research program for 2004-05 was endorsed by the Research Committee established by Australian Hearing to oversee the program. In the committee’s assessment, the research program had appropriate scientific merit and was consistent with the community service obligations of the Hearing Services Program.

NAL’s research findings are published in international journals and on the NAL website. During 2004-05, NAL had 23 articles accepted for publication, indicating a high level of acceptance of its research amongst clinicians and researchers within the hearing service industry. This high level of acceptance is also reflected in frequent requests for NAL staff to present (expenses paid) at leading conferences. NAL staff gave 28 presentations at national and international conferences during 2004-05.

The amount of information downloaded from the NAL website continued to grow in 2004-05, rising to 25,149 hits on the website per month by the end of the year.

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PART 2: PERFORMANCE INFORMATION


Performance Information for Administered Items


Administered Item 1. Provision of services for contestable clients, including:
  • those in receipt of a pensioner concession card, Department of Veterans’ Affairs Gold and White Repatriation (specifically for war related hearing loss) card holders, their dependants; and referred CRS Australia clients, Sickness Allowees, and Defence Force personnel.
Target: Quality: The extent to which client satisfaction levels with hearing services are maintained or improved compared to the last client satisfaction survey (ie 92% very satisfied or satisfied).

Result: Target met.

The results of the annual Office of Hearing Services Survey indicated that 94.6% of respondents were satisfied or very satisfied with the quality of hearing services they received from their chosen provider.

Target: Quantity: All clients who apply and are assessed as eligible, receive a voucher (estimated to be in the range of 180,000-200,000 vouchers in 2004-05).
Result: Target met. All clients who submitted a completed voucher application form and met the relevant eligibility criteria received a hearing services voucher. A total of 192,161 vouchers were issued during 2004-05.
Target: Efficiency: Maintain the existing average unit cost per voucher in real terms.
Result: Target met. The average unit cost per voucher ($793.03 in 2004-05) was maintained.
Target: Efficiency: Maintain the existing average unit cost per maintenance client in real terms.
Result: Target not met. The average unit cost per client for maintenance ($137.13 in 2004-05) increased by 1.2% in real terms. This is due to an increase in the proportion of binaurally fitted clients entering maintenance agreements (78% in 2004-05 compared with 74% in 2003-04).

Administered Item 2. Provision of Community Service Obligations, including:
  • hearing services to children and young adults under 21 years of age, eligible Aboriginal and Torres Strait Islander adults, eligible people who live in remote areas and eligible clients with complex needs; and

Target: Quality: The quality of services delivered to match or exceed present levels.
Result: Target met.

Revised quality outcome standards for the delivery of services to clients with complex hearing needs have been incorporated into the Memorandum of Understanding with Australian Hearing.

Target: Quality: The number of services delivered to match or exceed numbers of services delivered in previous financial year.
Result: Target met. The number of services delivered exceeded 2003-04 levels. In 2004-05, 47,443 services were delivered to children and young adults under 21 years of age, while 27,892 services were delivered to adults with complex hearing needs. During the previous year, 46,188 services were delivered to children and young adults, and 27,515 services to adults with complex hearing needs.
Target: Efficiency: Average activity cost (including amortised infrastructure cost) for each client category to be maintained.
Result: Target not met.

In 2004-05, the average cost per child client was $715.94 and the average cost per adult complex client was $809.91 (the average cost per Indigenous Australian client is reflected in the cost per child or adult client).

Direct comparisons with the average cost per child client and adult complex client during 2003-04 are not valid as a different methodology was used for calculating these costs during this period. There has been, however, an upwards trend in the average cost per child client which was largely due to a greater proportion of children requiring more intensive hearing services, along with an increase in the number of services provided to infants with a hearing loss. Infants assessed as suffering from a hearing loss are seen more frequently compared to other client groups, and require more resources (eg, the presence of two audiologists for some appointments).

  • research into hearing impairment, hearing rehabilitation and the harmful effects of noise.
Target: Quality: Complete approved research projects to a high standard i.e. the number accepted for publication in peer-reviewed journals to be maintained.
Result: Target met. During 2004-05, the National Acoustic Laboratories had 23 articles accepted for publication in peer-reviewed scientific journals. A total of 23 articles were accepted during the previous year.


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Performance Information for Departmental Outputs


Output Group 1. Policy advice, in relation to:
  • funding arrangements for the Voucher System and CSO;
  • enhancements to quality assurance arrangements;
  • the impact of new hearing aid technology on the program; and
  • other Hearing Services Program policy-related issues that arise from time to time.

Target: Quality: A high level of satisfaction of the Ministers, Parliamentary Secretary and Ministers’ Offices with the relevance, quality and timeliness of policy advice, Question Time Briefs, Parliamentary Questions on Notice and briefings.
Result: Target met.

The Minister and Minister’s Office were satisfied with the relevance, quality and timeliness of policy advice, Question Time Briefs, Parliamentary Questions on Notice and briefings.

Target: Quality: Timely production of evidence-based policy research.
Result: Target met. The Review of the Clinical Standards, conducted by the Joint Accreditation System of Australia and New Zealand on behalf of the Office, was completed in consultation with industry.

The Hearing Services Consultative Committee was established to provide the Minister for Ageing with advice on broad strategic directions for the provision of hearing services, and on emerging issues of concern. Its membership includes representatives of all relevant stakeholder groups within the hearing services industry, including consumer groups. At its inaugural meeting on 9 March 2005, the Committee prioritised areas for investigation and development of evidence-based policy advice.
Target: Quality: Opportunity for stakeholders to participate in policy and program development.
Result: Target met.

In 2004-05, the Office continued to consult with, and seek feedback from, key external stakeholders such as relevant professional bodies, peak consumer groups, clients, and hearing device manufacturers. The Office also undertook a range of consultative meetings with representatives of these groups throughout the year. Specific meetings and forums included:

  • a forum for manufacturers to discuss the proposed new device supply arrangements (December 2004);
  • Client Focus Groups held in February 2005;
  • the annual Office of Hearing Services Survey; and
  • Office representation and consultations at conferences and meetings of peak professional bodies.

Output Group 2. Program management, including:
  • program evaluation and monitoring;
  • developing, negotiating and managing contracts for provision of hearing aids and hearing services;
  • the payment of service providers by the Health Insurance Commission; and
  • financial management and reporting.
Target: Quality: A high level of stakeholder satisfaction with the timely development and implementation of national strategies.
Result: Target met.

The Office has successfully developed and implemented a number of national strategies aimed at enhancing hearing outcomes for clients and streamlining administrative processes. An example is the new procedure for the refitting of hearing devices which was implemented in 2004-05. The new procedure enables hearing service providers to proceed with the refitting of a hearing device, where clinically appropriate, without seeking prior approval from the Office. This has reduced the waiting times for clients requiring this service.

Stakeholder satisfaction is demonstrated by the acceptance of these strategies by relevant stakeholders. For example, 14 manufacturers, representing 93% of all manufacturers registered to supply devices in Australia, have formally agreed to the new device supply arrangements.

Target: Quality: Budget predictions are met and actual expenses vary less than 5% from budgeted expenses.
Result: Target met. Budget predictions were met and actual expenses varied by 3.7% from budgeted expenses.
Target: Quality: 100% of payments are made accurately and in accordance with negotiated service standards.
Result: Target met.

All payments were made accurately and in accordance with agreed service standards.

Target: Quality: A high level of stakeholder satisfaction with relevance, quality and timeliness of information and education services.
Result: Target met.

The Office produced and distributed information and education services to stakeholder groups through a range of media, for example:

  • providers received a quarterly Service Provider Bulletin and Service Provider Advice notices;
  • hearing device manufacturers were provided with written material and follow-up emails during negotiations of the new device supply arrangements; and
  • a general media release was issued to inform stakeholder groups and the wider community of the new arrangements.

Feedback collected through the 2004-05 Office of Hearing Service Survey indicated a high level of stakeholder satisfaction with the relevance, quality and timeliness of the above information/education services.

Target: Quantity: Between 140-160 service provider contracts and 12-18 Deeds of Standing Offer for device supply serviced.
Result: Target met. As at 30 June 2005, the Office held contracts with 181 service providers and 15 Deeds of Standing Offer with manufacturers of hearing devices.
  • Regulatory activity, including:
    • accrediting hearing aid manufacturers to supply hearing devices under the Program;
    • accrediting service providers for the provision of hearing services under the Program;
    • assessing hearing devices for approval for supply under the Program; and
    • conducting audits and following up on complaints to ensure compliance with:
  • the terms and conditions in Service Provider Contracts and Deeds of Supply for hearing devices;
  • hearing device standards;
  • Rules of Conduct;
  • Clinical Standards; and
  • Advertising Rules.

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Target: Quality: Evaluation of manufacturers for accreditation within two weeks of the manufacturer submitting all necessary information.
Result: Not applicable.

No manufacturer applied for accreditation during 2004-05.

Target: Quality: Evaluation of service providers for accreditation within two weeks of the provider submitting all necessary information.
Result: Target not met.

Of the 21 service providers accredited during 2004-05, 17 (81%) were successfully evaluated within 2 weeks of the Office receiving all necessary information. 3 of the remaining 4 providers who submitted applications for accreditation were accredited within 4 weeks, and the remaining provider was accredited within 6 weeks.

The delays in accrediting the latter 4 providers resulted from the need to seek legal advice regarding their business structure and competing demand-driven work priorities within the Office.

Target: Quality: Evaluation of new devices against quality standards completed within two weeks of manufacturers providing all necessary information.
Result: Target met.

The evaluations of all submissions for the approval of devices for supply under the Program were completed within 2 weeks of the Office receiving the required information.

Target: Quality: All applicants for a Hearing Services Voucher have eligibility checked by the appropriate agency.
Result: Target met. The eligibility requirements of all applications for a Hearing Service Voucher were checked by the appropriate agency.
Target: Quality: All providers are monitored for compliance with the terms and conditions of the Service Provider Contract.
Result: Target met. All contracted service providers were monitored through the Office’s information systems, to check and monitor compliance with the terms and conditions of the contract. Appropriate action was taken where necessary.
Target: Quality: All providers are monitored for compliance with Rules of Conduct, Clinical Standards and Advertising Rules.
Result: Target met.

All contracted service providers were monitored through the Office’s information systems, and a sample assessed through clinical/financial audits and file reviews. Feedback was provided in all instances of noncompliance, and non-complying providers were instructed to develop and implement improvement plans where necessary.

Several Service Provider Advice notes were issued to all providers to reiterate key requirements and standards for the delivery of hearing services under the Program.

Target: Quantity: Minimum of 40 audits conducted by the Office of Hearing Services within the contract period.
Result: Target met. A total of 50 audits (site audits, new provider audits, and audits of practitioners against the Refitting Guidelines) were conducted.
Target: Quantity: 20% of all practitioners have client files reviewed annually.
Result: Target met. 23% of all practitioners had their files reviewed. This is consistent with a continuing effort to work with new practitioners to ensure early contract compliance.
Target: Quantity: Approximately 200 devices per year are evaluated against specifications set out in the Deed of Standing Offer with manufacturers (subject to number of requests for evaluation and approval submitted by manufacturers).
Result: Target met. 275 hearing devices were evaluated and approved for listing on the Schedule of Approved Devices. These devices were assessed against the specifications contained in the Deed of Standing Offer with manufacturers.
Target: Quality: Appropriate compliance action taken when non-compliance is identified.
Result: Target met. Compliance action was initiated against 3 service providers in response to identified breaches of the Clinical Standards, the Rules of Conduct or contractual issues.


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Output Group 3. Agency specific service delivery, including:
  • the issuing of vouchers and information to clients;
  • resolution of client and service provider complaints; and
  • direct provision of information and manual claim services to service providers.
Target: Quality: All vouchers to be issued within 14 days of receipt of a correctly completed application.
Result: Target met.

On average, eligible clients were issued with a voucher within 7.7 working days of receipt of the completed form.

Target: Quality: High level of client satisfaction with services provided by the service provider.
Result: Target met. The results of the annual Office of Hearing Services Survey indicate that 94.6% of respondents were satisfied with the quality of hearing services they received from their chosen provider.
Target: Quantity: All eligible clients who apply for a voucher receive one.
Result: Target met.

All clients who submitted a correctly completed voucher application form and met the relevant eligibility criteria received a hearing services voucher. 192,161 vouchers were issued to eligible clients during 2004-05.

Target: Quality: Client and other complaints resolved within an average of 10 working days of receipt of the complaint.
Result: Target met. Client and other complaints were resolved within an average of 10.3 working days.
Target: Quantity: Number of complaints against 2000-01 benchmarks (670 complaints in 2000-01).
Result: Target not met.

A total of 2,755 complaints were received by the Office in 2004-05, compared to 2,131 complaints received during the previous year.

There has been a substantial increase in the number of complaints recorded by the Office since the 2000-01 benchmark was established. A major contributing factor has been the implementation of new complaints policies and procedures which define a complaint as ‘any expression of dissatisfaction, or any breach of conditions or standards relating to a product or service offered or provided’. This broader definition of complaints has led to a greater range of complaints being recorded and investigated. The Office has also actively encouraged and assisted clients to lodge complaints if and where they were dissatisfied with hearing services provided under the Program. These new procedures have assisted the Office in monitoring the delivery of hearing services.

The growth in complaints has also been due, in part, to a substantial increase in the number of clients accessing hearing services under the voucher system. For example, the number of active voucher clients increased from 325,821 in 2000-01 to 411,631 in 2004-05, an increase of 26%.





Produced by the Portfolio Strategies Division, Australian Government Department of Health and Ageing.
URL: http://www.health.gov.au/internet/annrpt/publishing.nsf/Content/performance-indicators-6
If you would like to know more or give us your comments contact: annrep@health.gov.au