Measure what matters most in healthcare—value, affordability and outcomes

Tuesday, August 20, 2019

‘Measuring the performance of our healthcare system is crucial to making better policy decisions—but we need to look to the future rather than the past in deciding what to measure’, says Australian Healthcare and Hospitals Association Chief Executive Alison Verhoeven.

‘And what matters most in modernised reformed health systems is what matters to patients—value, affordability and outcomes.’

Ms Verhoeven was responding to today’s release of a new online Australian Health Performance Framework by the Australian Institute of Health and Welfare (AIHW). The Framework is described as ‘a tool to support reporting on Australia’s health and healthcare performance’. It supersedes and replaces other frameworks.

‘The AIHW states that this is an initial release of already-existing data to support consultation ahead of a main release towards the end of 2019’, Ms Verhoeven said.

‘My feedback and that of our members to the AIHW and governments is that at the moment the framework looks heavily “input-centric”. It is looking backwards and counting numbers of consultations, health system costs, numbers of admissions for condition X, numbers of consultations (not people) bulk-billed, and so on.

‘These things are obviously important, but they are not the only game in town.

‘We need to collect information that measures outcomes of treatments, as reported by patients as well as health professionals. We need to collect information that leads us towards getting better bang for our buck in healthcare—towards the procedures that are of proven good value, to the situations where patients are getting the best outcomes at an affordable cost.

‘We need data that shows how often prescription renewals attract a doctor’s fee when it could have been done at less cost and no detriment to the patient as part of, say, a package of ongoing care.

‘We need to see the savings and outcomes that occur when using Practice Nurses to give injections instead of doctors. ‘We need to see which treatments are still in use and heavily subsidised by Medicare when more effective evidence-based treatments are available.

‘We need information that indicates with more precision where an injury treated in hospital could have been done just as effectively at a local primary care clinic for a fraction of the cost.

‘We need information that shows why a particular course of treatment in district X is appreciably more expensive than the same treatment in district Y.

‘Governments are aware of such issues. The Council of Australian Governments Heads of Agreement for the 2020–2025 National Health Agreement calls for “new long-term system-wide reforms for … Paying for value and outcomes”.

‘To effect such changes on a national scale, the Australian Government must use policy levers such as data reporting and performance measures linked to commissioning of services.

‘For example, Primary Health Networks around the country cannot optimise efficiency and effectiveness of medical services in their local areas when they do not have access to robust information on outcomes.

‘Let’s use data and performance reporting to drive towards an outcomes-focused health system that achieves better value in healthcare, addresses inequities, eliminates unwarranted variations and improves efficiency’, Ms Verhoeven said.

The Australian Healthcare and Hospitals Association is the national peak body for public and not-for-profit hospitals, and community and primary healthcare services.

Media enquiries:  Alison Verhoeven

Chief Executive, Australian Healthcare and Hospitals Association

0403 282 501