Aboriginal and Torres Strait Islander Health Performance Framework (HPF) 2012

Technical Appendix—Data development—South Australia (SA)

The HPF was designed to measure the impact of the National Strategic Framework for Aboriginal and Torres Strait Islander Health (NSFATSIH) and will be an important tool for developing the new National Aboriginal and Torres Strait Islander Health Plan (NATSIHP).

Page last updated: 15 November 2012

Improving Aboriginal and Torres Strait Islander Identification

ABS was funded through SA Health's COAG investment to develop a training package for recording the 'Indigenous identifier' in health data collections; as well as training staff who manage data and/or perform data entry about the importance of collecting the Indigenous identifier information; the correct way of asking the standard question and recording the response; and strategies for dealing with special circumstances, such as determining the Indigenous status of children and patients who are unconscious. The training targeted frontline staff working across hospital sites in metropolitan Adelaide and regional communities, as well as various mainstream primary care services throughout SA. This training approach was informed by the AIHW's Best Practice Guidelines for Collecting Indigenous Status. The first state-wide training program concluded in late 2011. Over 430 frontline staff attended training sessions held in 40 locations spread through the state. A second round of training is due to begin later this year.

SA Health has also indicated support to feed its initiative into the AIHW and ABS National Data Linkage Project on Indigenous identification. The Department continues to operate a case-mix payment system which applies a 30% loading to hospital separations of Aboriginal and Torres Strait Islander peoples, and this provides an incentive for improved Indigenous identification.

SA Pathology (trading as IMVS Pathology) provides a comprehensive diagnostic pathology service delivered via a network of 18 state-wide laboratories and more than 71 patient collection centres. It is the sole provider of pathology in the Public Hospital sector and a major provider to the private GP and Specialist market. SA Health and SA Pathology have recently completed the first part of the project to address "Aboriginal Identification Requirements in Pathology Systems".

The initial emphasis of the project has been to ensure the Indigenous Identifier on Pathology Forms is included. This involved extensive consultation with SA Pathology providers and other jurisdictional providers. This enabled information sharing and identifying lessons learnt from other jurisdictions implementing similar projects, and resulted in the Indigenous Identifier being introduced into Pathology forms as well as metropolitan based hospital systems. Whilst pathology forms have been addressed, a greater emphasis is now required to link the Indigenous identification data to an IT solution, as this is a significant gap that needs attention. The redevelopment of SA Pathology's Laboratory Information System, which aims to be completed by 30 June 2014, is a key IT solution that will integrate the Aboriginal information, and enable the use of captured data.

Further project work is being undertaken to review the downstream impacts on affected registries, which include input and advice from the Aboriginal community controlled health services, GP Clinics, Medicare Locals and Well Women's Cervical Screening programs. SA Health is determining how best to ensure systems provide consistent and continuous transfer of Aboriginal identification data across SA Health. Additional systems training will be required to support staff to collect information.

In 2007, SA participated in the national Audit of Indigenous Identification in Public Hospitals project, coordinated by the AIHW. Surveys were conducted in metropolitan and regional hospitals across SA, and the results contributed to reports from other jurisdictions to calculate adjustment factors to be applied to hospital separations data for Expenditure on Health reporting. A follow-up audit was conducted in 2011. The audit independently verified the Indigenous status of a sample of patients in selected metropolitan and country hospitals through face-to-face interviews. The results were matched against data held in hospital systems, to assess the quality of identification by hospital staff. More than 1,250 patient interviews were conducted during the audit. Results from the audit will be used to determine correction factors for adjusting national Indigenous performance indicator data for under-identification.

Aboriginal and Torres Strait Islander Life Expectancy Measures

SA Health is required under the South Australian Strategic Plan (SASP) and under COAG targets, to monitor Aboriginal and Torres Strait Islander peoples' life expectancy and has produced healthy life expectancy estimates for Aboriginal and Torres Strait Islander peoples in South Australia. These estimates were based on the Burden of Disease and Injury in Aboriginal and Torres Strait Islander Peoples 2003 and The Burden of Disease and Injury in Australia, 2003 (AusBoD) which provide a base for the SA Burden of Disease (SABoD) Series. The estimates inform Target T 79 "Aboriginal healthy life expectancy" in the SA Strategic Plan (SASP). SA Health is currently unable to update these estimates until access to cause of death CURF files is restored nationally.
  • SA NT DataLink is now operational and provides a statistical data linkage service within SA and the Northern Territory. Current, relevant de-identified datasets available include public hospital inpatient records, public hospital emergency departments, cancer registry, perinatal outcomes, public dental services and death registrations data. This has potential to become a sustainable environment for accessing data relevant to healthy life expectancy calculation. The possibility of imputation of Indigenous identification across linked datasets is a particular strength of data linkage projects.
  • The Department has recently completed its first ever SA Aboriginal Health Survey. The survey includes questions on health risk factors, health conditions and health related quality of life. A report presenting the results and findings of the survey will shortly be published on the SA Health website.
  • There are two major parts of the ongoing healthy life expectancy work in SA: mortality (life expectancy) and morbidity (health related quality of life, or the amount and severity of illness experienced).

Data Sets

Having identified the need for improvements in the way that the health sector describes and measures primary health care activities, SA has established an Out-of-Hospital Services Minimum Data Set, which includes the National Data Dictionary definition of Indigenous status, represents the agreed core elements that are collected for describing out-of-hospital care services in SA. A central repository of out-of-hospital services data has been established covering: community health, community mental health, public dental services, drug and alcohol services, child and family services, district nursing services and palliative care. It is now possible to track the use of the above services by Aboriginal and Torres Strait Islander peoples.Top of page

Data Sharing

The Aboriginal Health Council of SA (AHCSA) was funded for data sharing initiatives under SA Health's COAG investment. The spirit of the funding agreement is to enhance and influence cross sectoral Aboriginal and Torres Strait Islander Health planning and priority setting through data sharing between the Aboriginal and Torres Strait Islander community controlled health sector and SA Health. AHCSA is the peak community body on Aboriginal and Torres Strait Islander health matters in SA and provides secretariat services to ten member Aboriginal Community Controlled Health Organisations (ACCHOs). An initiative included the engagement of a consultant to conduct a Data Sharing Needs Analysis across the ACCHOs. The AHCSA data sharing consultant was responsible for:
  • Consulting with relevant SA Health personnel to ascertain what health-related data they consider would be useful to obtain from ACCHOs (and for what reasons), and what data SA Health would be amenable to provide to ACCHOs (and for what reasons);
  • Consulting with relevant personnel from ACCHOs to ascertain what health-related data they consider would be useful to obtain from SA Health (and for what reasons); and what data ACCHOs would be amenable to provide to SA Health (and for what reasons);
  • Monitoring national and state developments in the area of e-Health, on AHCSA's behalf, and prepare a short e-Health situational analysis for AHCSA; and
  • Preparing a report on potential data-sharing arrangements between SA Health and ACCHOs.
The consultant undertook this work from February to May 2011. During that period extensive consultation was undertaken with both SA Health personnel and ACCHO personnel. Both parties identified what they considered useful data to share, and why they considered such data useful. They identified challenges they currently experienced in their relationship with the other party with regards to health data, and factors limiting their current data sharing capabilities. This information was compiled into a report which also suggested methodologies to utilise to improve the relationship between ACCHOS and SA Health so as to arrive at a point where meaningful data sharing could occur. The report was finalised in May 2011, and copies circulated to all participants in the data sharing needs assessment project.

The consultant has continued to work with the ACCHOs in the field of the national eHealth initiatives, and has implemented some of the report's suggestions by regularly meeting with staff from SA Health's eHealth systems division to discuss ways that SA Health and the SA ACCHOs can utilise developments in the national eHealth space to enhance their capability to share data with each other.

The Aboriginal Health Council of SA receives funding through the Closing The Gap in Indigenous Health Outcomes National Partnership to support Aboriginal Community-Controlled Health Services in participating in the Audit and Best Practice for Chronic Disease (ABCD) National Research Partnership. The funding enables the provision of training in ABCD auditing, including the acquisition of required licensing for the use of the One21Seven auditing tool by:
  • Facilitating ABCD audit training to Aboriginal Community-Controlled Health Services; and
  • Enabling Aboriginal Community-Controlled Health Services staff to participate in the training by supporting travel and accommodation requirements.
Top of page