National Key Performance Indicators for Aboriginal and Torres Strait Islander primary health care

About nKPIs

In 2011, the Australian Health Ministers’ Advisory Council (AHMAC) approved a set of 24 nKPIs to track and evaluate the Closing the Gap health outcomes of Aboriginal and Torres Strait Islander people.

The nKPIs cover maternal and child health, chronic disease management and preventive health. They track:

• the Closing the Gap health outcomes
• progress towards achieving the goals of the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan.

Since June 2012, over 230 Government-funded Aboriginal Medical Services have reported nKPI data to us every January and July.

Since 2014, the Australian Institute of Health and Welfare has used this data to produce a range of indicator-based reports and annual reports on primary care.

This collection is now one of the most advanced primary health care datasets available in Australia. It collects both:

• process of care indicators – for example, blood pressure measured, birthweight recorded
• outcome (health status) data for regular clients – for example, blood pressure result, birthweight.

Purpose

The purpose of nKPIs is to:

• improve the delivery of primary health care services, by supporting continuous quality improvement activity among service providers
• support policy and planning at the national and state/territory level by monitoring progress and highlighting areas for improvement.

Redesign

A number of reviews resulted in recommendations to improve the nKPIs and Online Services Report.

These included clinical recommendations relating to changes to 22 out of 24 existing KPIs. Many of these were minor updates to the indicators to ensure they aligned with current clinical best-practice guidelines.

KPMG drew together and distilled the recommendations from various reviews to reduce duplication and overlap. This resulted in the nKPI and OSR Implementation Roadmap, which reduced the number of recommendations from 140 to 36. The Health Services Data Advisory Group (HS DAG) has endorsed the roadmap and we are working to implement it.

The 20 nKPIs

• PI01: Proportion of Indigenous babies born within the previous 12 months whose birthweight has been recorded  on more than one visit
• PI02: Proportion of Indigenous babies born within the previous 12 months whose birthweight results were recorded as low, normal or high  on more than one visit.
• PI03: Proportion of regular clients who are Indigenous, aged 0-14 years and had a Health Assessment completed within the previous 12 months, and proportion of regular clients who are Indigenous, aged 15 years and over and had a Health Assessment completed within the previous 24 months
• PI05: Proportion of regular clients who are Indigenous, have Type II diabetes who have had an HbA1c measurement result recorded within the previous six months and proportion of regular clients who are Indigenous, have Type II diabetes and who have had an HbA1c measurement result recorded within the previous 12 months
• PI06: Proportion of regular clients who are Indigenous, have Type II diabetes and whose HbA1c measurement result, recorded within either the previous six months or 12 months, was categorised as one of the following:
  • less than or equal to 7% (less than or equal to 53 mmol/mol); ^
  • greater than 7% but less than or equal to 8% (greater than 53 mmol/mol but less than or equal to 64 mmol/mol); ^
  • greater than 8% but less than 10% (greater than 64 mmol/mol but less than 86 mmol/mol); ^ or
  • greater than or equal to 10% (greater than or equal to 86 mmol/mol). ^
• PI07: Proportion of regular clients who are Indigenous, for whom a Chronic Disease Management Plan (MBS Item 721) was prepared within the previous 24 months
• PI09: Proportion of regular clients who are Indigenous, aged 11 years and over and whose smoking status has been recorded
• PI10: Proportion of regular clients who are Indigenous, aged 11 years and over and whose smoking status has been recorded as one of the following:
  • current smoker,
  • ex-smoker, or
  • never smoked.
• PI11: Proportion of regular clients who are Indigenous, younger than 20, 20-34 years old, or 35 years and older, who gave birth within the previous 12 months and whose smoking status has been recorded during their pregnancy as one of the following:
  • current smoker,
  • ex-smoker, or
  • never smoked.
• PI12: Proportion of regular clients who are Indigenous, aged 18 years and over and who have had their BMI recoded within the previous 24 months
  • BMI not calculated
  • BMI underweight
  • BMI normal weight
  • MNI overweight
  • BMI obese
• PI13: Proportion of regular clients who are Indigenous, who gave birth within the previous 12 months and who had gestational age recorded at their first antenatal care visit with results either:
  • before 11 weeks
  • 11 to 13 weeks
  • 14 to 19 weeks
  • 20 weeks or later
  • no result recorded
  • did not attend an antenatal care visit.
• PI14: Proportion of regular clients who are Indigenous, aged 6 months and over and who are immunised against influenza
• PI16: Proportion of regular clients who are Indigenous, aged 15 years and over and who have had their alcohol consumption status recorded within the previous 24 months
• PI18: Proportion of regular clients who are Indigenous, and who are recorded as having Type II diabetes and have had an estimated glomerular filtration rate (eGFR) recorded AND/OR an albumin/creatinine ration (ACR) or other micro albumin test result recorded within the previous 12 months.
  • Number and proportion of regular clients who are Indigenous, aged 15 years and over who are recorded as having cardiovascular disease (CVD) and have had an eGFR recorded within the previous 12 months
• PI19: Number and proportion of Indigenous regular clients with a selected chronic disease whose kidney function tests in the past 12 months indicate normal, low, moderate or high risk. 
• PI20: Number and proportion of regular clients who are Indigenous with no known cardiovascular disease (CVD) aged 18 to 74 years, with information available to calculate their absolute CVD risk.
• PI21: Proportion of regular clients who are Indigenous, aged 30 to 74 who have had an absolute CVD risk assessment recorded within the previous 2 years and whose CVD risk was categorised as one of the following:
  • High (greater than 15% chance of a cardiovascular event in the next 5 years).
  • Moderate (10-15% chance of a cardiovascular event in the next 5 years).
  • Low (less than 10% chance of a cardiovascular event in the next 5 years).
• PI22: Proportion of regular female clients who are Indigenous, aged 25 to 74 years, who have not had a hysterectomy and who have had a cervical screening (HPV) test within the previous 5 years.
• PI23: Proportion of regular clients who are Indigenous, have Type II diabetes and who have had a blood pressure measurement result recorded within the previous 6 months.
• PI24: Proportion of regular clients who are Indigenous, have Type II diabetes and whose blood pressure measurement result, recorded within the previous 6 months, was less than or equal to 140/90 mmHg.