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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 7 followed by a brief description of the Department’s performance in meeting these targets.

Indicator 1. Improving health outcomes for Aboriginal and Torres Strait Islander peoples by promoting the delivery of culturally appropriate high quality health care

Target:

Improvements across a range of indicators related to risk markers and intermediate health outcomes.

Information source/reporting frequency:

Biennial Report of National Performance Indicators for Aboriginal and Torres Strait Islander Health and other published reports.


Evidence from research and administrative data shows significantly improved health outcomes in response to improved local delivery of health care interventions, for example:
  • a study in the Torres Strait involving the use of a comprehensive diabetes management program led to a 20 per cent reduction in hospital admissions;
  • as a part of its child and maternal health program, a South Australian health service has demonstrated increases in attendance for antenatal care. Low birth weight rates have fallen from around 15 per cent in the mid 1980s to 5-6 per cent in 2003. Childhood immunisation rates have increased from around 60 per cent to close to 100 per cent today;
  • no cases of Haemophilus influenzae type b (Hib) meningitis have occurred in Indigenous children in Far North Queensland in the 10 years since the introduction of Hib vaccinations to the Standard Vaccination Schedule in 1993. Prior to this time the rate of this disease was 3.5 times greater in Indigenous children than in non-Indigenous children, resulting in 28 cases of Hib meningitis in Indigenous children aged under 5 years in far North Queensland in the years 1989-1992;
  • Donovanosis notifications have continued their decline from 121 cases in 1994 to 11 cases in 2004; and
  • specifically targeted maternal and child health programs have produced declines in preterm births from 16.7 per cent to 8.7 per cent, a rate comparable with the general population.
Indicator 2. Per capita funding for primary health care for Aboriginal and Torres Strait Islander peoples across all government health programs

Target:

Increase in future years of spending on primary care as a proportion of all health care spending for Aboriginal and Torres Strait Islander peoples.

Information source/reporting frequency:

Reports on Expenditures on Health Services for Aboriginal and Torres Strait Islander people. The reports are prepared triennially for the Department.


The Expenditures on Health for Aboriginal and Torres Strait Islander Peoples report covering the 2001-02 financial year provides the most recent data on national expenditure on Indigenous health. The share of expenditure on primary health care across all government health programs for Aboriginal and Torres Strait Islander peoples decreased slightly from 45.7 per cent in 1998-99 to 45.5 per cent in 2001-02. However, government primary health care expenditure per Indigenous person grew from $1,550 to $1,739 from 1998-99 to 2001-02 (in 2004-05 dollars).

Indicator 3. Number of health professionals (doctors, nurses and health workers) in Australian Government funded Aboriginal health services; and the number of Indigenous students who have graduated from tertiary degree training in medicine and nursing

Target:

Increase in numbers in each category.

Information source/reporting frequency:

Service Activity Reports provided to the Department of Health and Ageing and National Performance Indicators biennial reports.



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The most recent data available shows that as at 30 June 2004 a total of 1,103 health professionals positions were employed in 138 Australian Government funded Aboriginal and Torres Strait Islander primary health care services, comprising full-time equivalent doctors (196 positions), nurses (275 positions) and Aboriginal and Torres Strait Islander Health Workers (632 positions). Overall there was a 4 per cent increase in the year to 30 June 2004. Aboriginal and Torres Strait Islander Health Workers increased by 3 per cent, doctors increased by 5 per cent and nurses by 6 per cent over the year.

There were also an additional 64 full-time equivalent visiting or separately funded positions comprising doctors (18 positions), nurses (16 positions) and Aboriginal and Torres Strait Islander Health Workers (30 positions), an overall increase of 23 per cent.

Between 2001 and 2003 the number of Indigenous students in tertiary level health related courses steadily increased. Most recent available data from the Department of Education Science and Training on Indigenous student doctors and nurses indicated there were 8 medical graduates in 2001 and 15 in 2002. There were 55 nurse graduates in 2001 and 44 in 2002.

Indicator 4. Data improvement on the performance of government programs to improve the health outcomes of Aboriginal and Torres Strait Islander peoples

Target:

Data collection improved through the National Performance Indicators for Aboriginal and Torres Strait Islander health and a comprehensive range of data sets, and of sufficient quality to support policy development.

Information source/reporting frequency:

Biennial reports on the National Performance Indicators held by the National Health Information Management Group.


Improving data collections has proved a slow process. The voluntary Indigenous identifier is a data improvement measure introduced into the Medicare database in November 2002. By June 2005, 80,658 people had identified as Indigenous.

Further improvement in Indigenous health data was pursued during 2004-05 through the Department’s work with the National Advisory Group on Aboriginal and Torres Strait Islander Health Information and Data, a sub-committee of the Australian Health Ministers’ Advisory Council. The Department pursued data improvements, through a number of avenues including:
  • working with the Australian Bureau of Statistics (ABS), Australian Institute of Health and Welfare (AIHW) and jurisdictions on administrative data quality and availability;
  • contributing funding towards an ABS Indigenous Health Survey program; and
  • working with the AIHW and jurisdictions on the National Performance Indicators for Aboriginal and Torres Strait Islander Health.
During 2004-05, the Department also provided a significant contribution to the development of the new Aboriginal and Torres Strait Islander Health Performance Framework which is being auspiced by the Standing Committee on Aboriginal and Torres Strait Islander Health. This Framework has been developed to provide the basis for quantitative measurement of the impact of the National Strategic Framework for Aboriginal and Torres Strait Islander Health. It will replace the existing National Performance Indicators and will provide the focus for improvements in Indigenous health data in the longer term.

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PART 2: PERFORMANCE INFORMATION


Performance Information for Administered Items <br>Administered Item 1. Aboriginal and Torres Strait Islander health:
  • comprehensive primary health care services, eg population health programs, clinical care, screening, immunisation, health education and promotion, counselling and specific programs such as sexual health, emotional and social wellbeing, substance use prevention; and
  • substance use specific services, eg prevention, early intervention and residential rehabilitation services.
Target: Quantity: At least 152 organisations providing and/or purchasing primary health care (may include substance use and emotional and social wellbeing).

Result: Target met.

 

168 organisations were funded in 2004-05 to provide primary health care services.

 

Target: Quantity: At least 66 services undertaking a range of substance use measures including prevention, early intervention and treatment in relation to substance use (figure incorporates 23 services included in the preceding measure which provide both substance use and other primary health care services).
Result: Target met. 67 substance use specific and health services (including 24 services included in the preceding measure) provided a range of substance use measures including prevention, intervention and treatment.
Target: Quantity: At least 1 million episodes of care provided.
Result: Target met. In the year 2003-04, Australian Government-funded Aboriginal and Torres Strait Islander Health Services provided an estimated 1.6 million episodes of care to clients. 89% (1.4 million) of these episodes were for Aboriginal and Torres Strait Islander clients.
Target: Quantity: At least 57 communities benefiting from new or expanded services as a result of the Primary Health Care Access Program.
Result: Target met. Funding was approved through the Primary Health Care Access Program for service expansion and enhancement for 64 regions in 2004-05.
Target: Quantity: In collaboration with other agencies, projects to improve living conditions in at least 2 remote communities.
Result: Target met. This measure has been met through the 2005 Army Aboriginal Community Assistance program which was, in 2004-05, part funded by the Department. Improvements have been made to the infrastructure within the Yiyili, Kadjina and Yakanarra communities located in the Kimberley region of Western Australia.
Target: Quantity: At least 31 substance use specific services providing residential rehabilitation services.
Result: Target met. 31 substance use specific services provided residential rehabilitation services.
Target: Quantity: At least 100 Bringing Them Home Counselling Positions.
Result: Target met. The Australian Government provided funding of $9.786 million in the 2004-05 financial year for 106 Bringing Them Home Counsellor Positions (including 16 part time positions) in Aboriginal Community Controlled Health Services (ACCHS) across the country.
Target: Quantity: 75% of primary health care services using computerised client information systems.
Result: Target met. A total of 92 out of a possible 121 Australian Government funded primary health care services have a patient information recall system either in place or under installation. This represents more than 76% of all primary health care services considered likely to benefit from the use of these systems.
Target: Quantity: 17 new clinic redevelopments/improvements and 15 new health staff houses/ duplexes in remote areas.
Result: Target not met. Of the planned 17 new clinics only 14 have been completed. The uncompleted projects have been delayed due to various factors within each project. These include construction delays, changes in senior staff within the Organisation’s Board through to insufficient infrastructure to meet the building demands.

The planned provision of 15 houses/duplexes being provided for health professional staff was met.

Target: Quantity: At least 80% of funded services routinely implementing population health promotion and education programs.
Result: Target met. The most recent data available on Australian Government-funded ACCHS is the 2003-04 Service Activity Report. 99% of Services reporting in the survey implemented population health and education programs. Of the 41 Australian Government-funded drug and alcohol services reporting in 2003-04, 95% provided some form of health lifestyle training or activities, and 83% provided at least one social health program.
Target: Quality: 100% of substance use specific services in South Australia are engaged in steps towards accreditation as part of a Quality Assurance pilot.
Result: Target met. The Quality Assurance pilot was completed in 2003. The engagement of an independent consultant to evaluate the pilot is awaiting the outcome of a tender evaluation process conducted by the Department in 2004-05. The expectation is that the evaluation will be completed during 2005-06.
  • Infrastructure to support the development and operation of high quality health care services for Aboriginal and Torres Strait Islander peoples, including:
  • workforce development;
  • specific health strategies;
  • data, evaluation and research;
  • service development activities; and
  • support for advocacy and representation.

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Target: Quality: Reduction in the number of funded services reporting difficulty with the management of human or financial resources, or equipment.
Result: Target met.

During the reporting period, OATSIH implemented a more comprehensive Risk Assessment Process to identify concerns earlier and to then implement corrective action. This process identified 20 organisations of serious concern (7.8% of total organisations funded in 2004-05) which is a decrease on the 9% of organisations in this category in 2003-04 and 35 organisations of concern (13.7%), a category not previously recorded.

Target: Quality: At least 80% of primary health care services implementing screening.
Result: Target met. Of 138 Service Activity Reporting services in 2003-04, 88% implement at least one screening program, while 35% implement as many as 8. The most commonly implemented programs were diabetic screening (113 services), PAP screening (109 services) and hearing screening (100 services).
Target: Quality: Provision of resources to provide active Indigenous community participation and advocacy in policy planning and implementation.
Result: Target met. The Department delivered Australian Government funding to the National Aboriginal Community Controlled Health Organisation; the Aboriginal Medical Services Alliance of the Northern Territory; the Queensland Aboriginal Islander Health Forum; Winnunga Nimityjah in the Australian Capital Territory; the National Aboriginal and Torres Strait Islander Health Council; and to the Health Partnership Forums in each State and Territory. Stakeholders were able to provide active Indigenous community participation and advocacy in policy planning and implementation through workshops, committees and consultation processes.
Target: Quantity: At least 35 organisations funded to provide training and education programs recruitment and support services.
Result: Target met. The Department funded 17 organisations to conduct education and training and 18 organisations to undertake recruitment and support (total 35 organisations funded).
Target: Quantity: At least 10 projects to provide information and/or improve the quality of data on Aboriginal and Torres Strait Islander health and mental health client needs and/or service provision issues.
Result: Target met. The Department delivered funding to 12 projects, including a project that aims to develop, for the first time, estimates of the burden of disease in the Aboriginal and Torres Strait Islander population.
Target: Quality: At least 95% of services completing Service Activity Reporting.
Result: Target met. In the year 2003-04, Service Activity Reporting was completed by 99% of services (139 out of 140 eligible).
Target: Quantity: At least 20 services utilising the Service Development and Reporting Framework and have received funding for a quality improvement initiative.
Result: Target met. 34 services used the Service Development and Reporting Framework with 32 of those services accepting quality improvement initiative funding.


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Performance Information for Departmental Outputs


Output Group 1. Policy advice, in relation to:
  • providing policy advice on improving the access of Aboriginal and Torres Strait Islander peoples to comprehensive and effective primary health care for Indigenous peoples and improved access to mainstream health and ageing programs.

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. OATSIH funds a variety of external research projects to improve access to primary health care services for Aboriginal and Torres Strait Islander peoples. These projects are orientated toward improving the responsiveness of the mainstream health system; providing complementary action through Indigenous specific research projects; and collaboration between research networks to plan and support programs of research in priority areas.
Target: Quality: Opportunity for stakeholders to participate in policy and program development.
Result: Target met. The Department provided funding of $2.265 million to the National Aboriginal Community Controlled Health Organisation, the Aboriginal Medical Services Alliance of the Northern Territory and to the Queensland Aboriginal, Islander Health Forum and Winnunga Nimityjah in the Australian Capital Territory, to enable these stakeholders to participate in policy and program development through workshops, committees and consultation processes. Support was also provided to the National Aboriginal and Torres Strait Islander Health Council to enable the Council to participate in those processes.

Output Group 2. Program management, including:
  • development of improved contracts, tenders and project management;
  • development of grant administration framework;
  • community liaison and support for the development and implementation of programs;
  • effective administration and resource management; and
  • financial management and reporting on Outcome 7.
Target: Quality: A high level of external stakeholder satisfaction with the timely development and implementation of national strategies.
Result: Target met. The Department provided information to key advisory bodies including the Australian Health Ministers’ Advisory Council and the National Aboriginal and Torres Strait Islander Health Council. Stakeholders generally indicated Department advice and input was of a high quality and provided in a timely manner.
Target: Quality: Budget predictions are met and actual expenses vary less than 5% from budgeted expenses.
Result: Target met. During 2004-05, full expenditure and commitment of funds was achieved with 100% of budget predictions being met.
Target: Quality: 100% of payments are made accurately and in accordance with negotiated service standards.
Result: Target met. During 2004-05, 1,672 payments were made by the Department to funded organisations. 100% of payments were made within 30 days of the nominal payment date.
Target: Quality: A high level of external stakeholder satisfaction with relevance, quality and timeliness of information and education services.
Result: Target met. Feedback from stakeholders is generally unsolicited. Many favourable comments have been received in relation to the Indigenous Health Matters biannual newsletter and the OATSIH maintained web pages within the Department's website. In addition, favourable comments have been received through the OATSIH enquiries e-mail database from health professionals, researchers and students noting their satisfaction with the quality of the information and resources provided to these stakeholders.
Target: Quantity: 502 grants, 288 contracts and 7 Memoranda of Understanding administered.
Result: Target met. 717 grants, 333 contracts and 7 Memoranda of Understanding were administered during the reporting period.


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-7
If you would like to know more or give us your comments contact: annrep@health.gov.au