Performance reporting is widely recognised in our modern world as a system to measure contribution, help identify strengths and areas for improvement, and to provide a yardstick for evaluation against peers. In recent years, with the start of health performance reporting at the hospital level and local level in Australia, we saw a shift that would have substantial impacts.
When the Council of Australian Governments agreed to the National Health Reform Agreement, it set out that Australian, state and territory governments would work in partnership to develop our health system through focusing on performance of individual hospitals and local health care organisations—currently Primary Health Networks (PHNs).
‘Performance information at this local level can open up new avenues of improvement in health outcomes and service delivery, basically informing those who know their local areas, and can make a difference,’ said Michael Frost, Head of the AIHW Communications and Primary Health Care Group.
Hospitalisations for mental health conditions and intentional self-harm in 2014–15 is an example of the difference local reporting can make. This report recorded hospitalisations by the postcode of residence of patients. It revealed higher rates of hospitalisations for mental health conditions and intentional self-harm in regional PHN areas—at 999 hospitalisations per 100,000 people—compared with 888 hospitalisations per 100,000 people in metropolitan PHN areas.
‘Being able to report on local areas gives us insight into our local health and identifies gaps. This can prove a vital resource for policy makers, communities, service providers and local councils,’ said Michael Frost, Head of AIHW Communications and Primary Health Care Group.
Mr Frost said, ‘Being able to report on local areas gives us insight into our local health and identifies gaps. This can prove a vital resource for policy makers, communities, service providers and local councils’.
It can also be a vital tool in recognising potential health dangers. The most recent local report, ‘Healthy Communities: Immunisation rates for children in 2015–16, presented local-level child immunisation information to help clinicians and health managers target their efforts to protect the health of children and the broader community. While overall immunisation rates had improved, the report identified some PHN areas that were lagging behind the national average.
‘A “one size fits all’ approach won’t always work and if we can help improve the system for individuals and inform targeted responses, we will see communities receiving the very best from their local health care systems,’ said Mr Frost.
We can also see these data inform local policy. Australia’s first local-level breakdown of adult tobacco smoking rates, released in October 2013, revealed the percentage of adults who were daily smokers for each of the 61 Medicare Local areas, which have since been replaced by PHNs.
The National Heart Foundation used these data as part of a grass-roots campaign to advocate for smoke-free areas in Tamworth.
‘We started to use the statistics in our media releases to help make the argument to council, and to say there’s a reason to do this,’ said Penny Wilson, the Heart Foundation’s Regional Health Promotion Coordinator for New England.
The National Heart Foundation’s campaign for smoke-free zones across Tamworth was unanimously backed by council in November 2015.
Mr Frost believes this appreciation for data is also echoed among the media, with local journalists regularly asking for localised information. This was seen in November 2014 when the AIHW published 2013 data on smoking, risky alcohol consumption and the use of illicit drugs for 87 regions (SA4s), which received widespread coverage. The Institute will release equivalent data for 2016 at the PHN level in late September 2017, again highlighting the importance the Institute places on localised data.
‘While it’s important to think nationally, we can also inform local-level service planning and efforts to make a real difference in people’s lives and their overall wellbeing,’ said Mr Frost.
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