Summary
This third national report on the Indigenous primary health care national Key Performance Indicators (nKPIs) data collection presents information on indicators collected over 6 reporting periods between June 2012 and December 2014. Data for this collection are provided to the AIHW 6-monthly by primary health care organisations who receive funding from the Australian Government Department of Health and state and territory health departments to provide services to Aboriginal and Torres Strait Islander people. The number of organisations reporting increased substantially over the 6 reporting periods, from 90 in June 2012 to 233 in December 2014.
The purpose of the nKPIs is to support policy and planning at the national and state/territory level by monitoring progress and highlighting areas for improvement. The nKPIs can also be used to improve the delivery of primary health care services by supporting continuous quality improvement (CQI) activity among service providers.
Information is presented against 21 indicators (and 27 key indicator measures-19 process-of-care measures and 8 health outcomes measures) that focus on maternal and child health, preventative health and chronic disease management.
Processes of care are largely under the control of organisations, so process-of-care measures are used to assess primary health care practices. However, the ability of some organisations to undertake some process-of-care functions can be affected by external factors such as staffing levels, funding constraints or access to shared information.
Many of the wide range of factors influencing health outcomes, on the other hand, are beyond the immediate control of primary health care organisations.
Improvements were seen in 17 of the 19 process-of-care measures ( Table S1). Organisations in Western Australia in particular showed improvements against most process-of-care indicators, as did those in Very remote areas.
Improvements were also seen in 3 of the 8 health outcomes measures (note that trend data were available for only 5 of the 8 health outcome measures):
- smoking status results-the proportion of current smokers declined from 54% in June 2013 to 52% in December 2014
- health of clients with type 2 diabetes-those who had an HbA1c (glycosylated haemoglobin) result of ≤7% in the previous 6 months rose from 32% in June 2012 to 35% in December 2014. (An HbA1c result of ≤7% is the optimum target encouraged by Diabetes Australia to ensure good glycaemic control and reduce the incidence of diabetes-related illness.)
- blood pressure result for clients with type 2 diabetes-the proportion who had a blood pressure result of ≤130/80 mmHg increased from 40% in June 2012 to 44% in December 2014.
A group of organisations that were followed up through 4 reporting periods show significant improvements for many process-of-care indicators. For example, on average, every 6 months 'Smoking status recorded' increased by 5.8 percentage points, 'MBS health assessments-adults aged 25 and over' increased by 2.7 percentage points and 'General Practitioner Management Plan-clients with type 2 diabetes' increased by 2.5 percentage points.
Preliminary material: Acknowledgments; Abbreviations; Symbols; Implications
Chapter 1 Introduction
- The nKPI collection
- nKPI data quality
- Clients
- Organisations contributing nKPI data
Chapter 2 Organisation performance on maternal and childhealth indicators
- Why are these important?
- Summary of progress
- Things to consider when interpreting data for these indicators
- First antenatal visit
- Birthweight recorded
- MBS health assessment (item 715) for children aged 0-4
- Child immunisation
- Birthweight result
- Smoking status of women who gave birth in the previous year
Chapter 3 Organisation performance on preventative health indicators
- Why are these important?
- Summary of progress
- Things to consider when interpreting data for these indicators
- Smoking status recorded
- Alcohol consumption recorded
- MBS health assessment (item 715) for adults aged 25+
- Cervical screening
- Immunised against influenza-clients aged 50 and over
- Smoking status result
- BMI classified as overweight and obese
Chapter 4 Organisation performance on chronic disease management indicators
- Why are these important?
- Summary of progress
- Things to consider when interpreting data for these indicators
- General Practitioner Management Plan-clients with type 2 diabetes
- Team Care Arrangement-clients with type 2 diabetes
- Blood pressure recorded-clients with type 2 diabetes
- HbA1c result recorded-clients with type 2 diabetes
- Kidney function test recorded-clients with type 2 diabetes
- Kidney function test recorded-clients with cardiovascular disease
- Immunised against influenza-clients with type 2 diabetes
- Immunised against influenza-clients with chronic obstructive pulmonary disease
- Blood pressure result-clients with type 2 diabetes
- HbA1c result-clients with type 2 diabetes
- Kidney function result-clients with type 2 diabetes
- Kidney function result-clients with cardiovascular disease
Chapter 5 Analyses of trends in performance
- Change in the mean value over time
- Regression-based time trend estimates
Chapter 6 Organisation results against process-of-care indicators
- Data
Chapter 7: Discussion
Appendixes
Appendix 1 Background to the nKPI collection and indicatortechnical specifications
Appendix 2 Data quality
Appendix 3 Comparison of nKPI results
Appendix 4 nKPI time trend results by jurisdiction and remoteness
Appendix 5 nKPI results by age group and sex
Appendix 6 Jurisdiction and remoteness variation figures
Appendix 7 Guide to the figures
End matter: Glossary; References; List of tables; List of figures; List of boxes; Related publications