TOWARDS INTEGRATED AND COHERENT HEALTH INFORMATION SYSTEMS: AN AUSTRALIAN POLICYMAKER S PERSPECTIVE
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1 TOWARDS INTEGRATED AND COHERENT HEALTH INFORMATION SYSTEMS: AN AUSTRALIAN POLICYMAKER S PERSPECTIVE Response to Michael Wolfson and Richard Alvarez s presentation: Towards integrated and coherent health information systems for performance monitoring: the Canadian experience ANDREW PODGER SECRETARY COMMONWEATH DEPARTMENT OF HEALTH AND AGED CARE, AUSTRALIA
2 Australian context Sixth largest land mass in the world Population of 20 million Average life expectancy: 76 years for males 82 years for females 23% of residents born overseas Health expenditure is 8.5% of GDP
3 Australian Health Performance Framework A: HEALTH STATUS AND OUTCOMES How healthy are Australians? Is it the same for everyone? Where is the most opportunity for improvement? Health Conditions Prevalence of disease, disorder, injury or trauma or other healthrelated states. Human Function Alterations to body, structure or function (impairment), activities (activity limitation) and participation (restrictions in participation). Life Expectancy and Wellbeing Broad measures of physical, mental, and social wellbeing of individuals and other derived indicators such as Disability Adjusted Life Expectancy (DALE). Deaths Age and/or condition specific mortality rates.
4 B:Determinants of Health Are the factors determining health changing for the better? Is it the same for everyone? Where and for whom are they changing? Environmental Factors Socioeconomic Factors Physical, chemical and biological factors Socioeconomic factors such as education, employment and income Community Capacity Characteristics of communities that can influence health Health Behaviours Risk factor attitudes, beliefs, knowledge and behaviours Person-related Factors Genetic related susceptibility
5 C:Health System Performance How well is the health system performing in delivering quality health actions to improve the health of all Australians? Effectiveness Desired outcome achieved Responsiveness Client-orientated and respecting persons Continuity Uninterrupted and coordinated care Is it the same for everyone? Appropriateness Relevant to client's needs and based on established standards Accessibility Ability to obtain health care at the right place and time Capability Individuals and services have skills and knowledge Efficiency Cost-effective use of resources Safety Prevention or minimisation of adverse events from health action Sustainability Infrastructure, innovation, emerging need capacity of system or organisation
6 OECD Proposed Health System Performance Framework Health improvement/outcomes (+) Responsiveness and access (+) Financial contribution/health expenditure (-) Average level Distribution = = = = = = Efficiency Adapted from Murray, C.J.L and Frenk, J. (2000) Equity
7 Australian Agencies and Agreements Involved in Health Information COMMONWEALTH AGENCIES Commonwealth Department of Health and Aged Care Health Insurance Commission (HIC) Australian Bureau of Statistics (ABS) COMMONWEALTH AGENCIES WITH SHARED GOVERNANCE WITH THE STATES Australian Institute of Health and Welfare (AIHW) National Health and Medical Research Council (NHMRC)
8 Australian Agencies and Agreements Involved in Health Information COMMONWEALTH/STATE AGREEMENTS Australian Health Care Agreements National Public Health Outcomes Funding Agreements National Health Information Agreement STATE AND TERRITORY AGENCIES State and Territory Health Authorities Area Health Authorities (varying arrangements in each State/Territory)
9 Health Performance Planning and Development Framework Australian Health Ministers National Health Information Management Advisory Council Australian Health Ministers Advisory Council (AHMAC) Health Connect Taskforce National Health Information Management Group (NHIMG) National Health Performance Committee National Health Data Committee (NHDC)
10 HealthConnect Record Quality of Life Maintenance Family History illness indicators Screening & Prevention Immunisation Care & Maintenance Consumer Focus Screening & Prevention Early Onset Remedial Maintenance
11 Desirable Health Performance Indicator Characteristics worth measuring measurable for diverse populations understood by people who need to act galvanise action relevant to policy and practice measurement over time reflects results of actions feasible to collect and report data definitions comply facilitate benchmarking consistent, using established indicators where possible
12 THE END
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