About the nKPIs
We currently use 20 indicators to track and evaluate progress towards achieving:
- the goals of the National Aboriginal and Torres Strait Islander Health Plan
- the Closing the Gap health outcomes and priority reforms.
The nKPIs are made up of both process of care and outcome indicators covering three major themes:
- maternal and child health
- chronic disease management
- preventative health.
Purpose
By collecting nKPIs, we:
- support continuous quality improvement (CQI) activity among service providers, improving the delivery of primary health care services
- monitor progress and highlight areas for improvement, supporting policy and planning at the national, state and territory level
Since 2014, the Australian Institute of Health and Welfare (AIHW) has used this data to produce a range of indicator-based reports and annual reports on primary care.
The Online Services Report (OSR) is a companion to the nKPIs and collects national data annually on the characteristics of these Indigenous Australians' Health Programme (IAHP) funded medical services, along with the activities and services they provide.
Workflow
There four stages to the nKPI submission and publication process:
- Health services provide clinical care to their patients and record data in their Clinical Information System (CIS)
- Health services submit their nKPI data to the Health Data Portal (HDP) every January and July. Services can directly export their data from their CIS into the HDP.
- In collaboration with the AIHW, we review the nKPI data in the HDP, ensuring it is as accurate as possible.
- The data is published by the AIHW as a national dataset, provided to health services for CQI – enabling services to make comparisons against other services and examine their performance over time, and used by the department to inform and evaluate policy.
Uses of the data
The Commonwealth may use nKPI data as specified in the agreement between each health service and the Department of Health and Aged Care. They can use nKPI data to:
- monitor the activity of health services
- identify areas of need
- inform policy development and program delivery
- support continuous quality improvement
- measure service delivery
- improve service delivery
- improve health outcomes
- support progress towards Closing the Gap targets
- reduce the burden of reporting
- brief the responsible Minister.
History and redesign
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.
Since June 2012, over 230 services have reported nKPI data to the department in January and July.
In 2018, we engaged KPMG to merge recommendations from multiple data collection projects and create an nKPI and OSR Implementation Roadmap. The roadmap includes recommendations for improvements in clinical, policy, technical and administrative areas. The Health Services Data Advisory Group (HS DAG) endorsed the roadmap in December 2019 and are working towards its implementation.
In 2019, health services started submitting their data to the department via the Health Data Portal (HDP). Where possible, health services extract nKPI data from their CIS to prevent human calculation errors.
Future improvements
The OSR and nKPI collections are reviewed by the Health Services Data Advisory Group every five years to ensure that they remain fit for purpose while minimising health services’ reporting burden.
We aim to continue refining the nKPI collection in 2024–2025, following the release of the NACCHO Core Services and Outcomes Framework. This framework will form part of the planned 2024 OSR/nKPI review. The recommendations from this review will help to guide future improvements to the nKPIs.
Current Indicators
- 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.
Indicators in pilot
- PI25: Number and proportion of Indigenous regular clients aged 15–34 who were tested for one or more sexually transmissible infections (STIs) (chlamydia and/or gonorrhoea) within the previous 12 months.
- PI26: Number and proportion of Indigenous regular clients aged 0–14 years who have a completed ear health check recorded in the previous 12 months.
Retired indicators
- PI04: Proportion of Indigenous children who are regular patients, aged 12 to 72 months and who are 'fully immunised'.
- Last collected in the June 2020 nKPI collection.
- PI08: Proportion of regular patients who are Indigenous, have a chronic disease (type 2 diabetes) and for whom a Team Care Arrangement (MBS Item 723) was claimed within the previous 24 months.
- Last collected in the June 2020 nKPI collection.
- PI15: Proportion of regular patients who are Indigenous, aged 15–49, are recorded as having type 2 diabetes and are immunised against influenza, and proportion of regular patients who are Indigenous, aged 15–49, are recorded as having chronic obstructive pulmonary disease and are immunised against influenza.
- Last collected in the June 2021 nKPI collection.
- PI17: the proportion of First Nations regular clients aged 15 and over who had an AUDIT-C result recorded within the previous 24 months with a score of either high risk (greater than or equal to 4 in males and 3 in females) or low risk (less than 4 in males and 3 in females).
- Last collected in the June 2022 nKPI collection.
