The Health System Indicators framework: measuring how well the health and disability system serves New Zealanders.
Everybody should have access to high quality health care, no matter who they are and no matter where they are in the country.
Measuring the health and disability sector’s performance is critical to improve equity, and for tracking progress towards better health and wellbeing.
The Health System Indicators framework measures and reports how well our health and disability system is doing for New Zealanders.
The new framework replaces health targets, the previous national performance measures for our health services.
About the framework
The Health System Indicators Framework is a new approach to health system performance measurement. The framework is premised on shared accountability. The Government sets high-level goals for the system; the Ministry and the Health Quality & Safety Commission (Commission) develop high level indicators for those goals with input from the health sector; and local providers work with their communities to agree what actions are needed to contribute to the high-level goals.
Work to implement the framework is underway during 2021/22. The Government has chosen an initial set of 12 national, high-level indicators for the framework that align with its priorities and will help the health and disability system to focus on the areas where improvement is needed the most. Ten of these indicators have been reported since August 2021 and a further two indicators are in development over 2021/22. The indicators are reported on an online dashboard developed by the Commission for reporting improvements on the Health System Indicators.
|Government priority||High-level indicator||Description|
|Improving child wellbeing||Immunisation rates for children at 24 months||Percentage of children who have all their age-appropriate schedule vaccinations by the time they are two years old|
|Ambulatory sensitive hospitalisations for children (age range 0–4)||Rate of hospital admissions for children under five for an illness that might have been prevented or better managed in the community|
|Improving mental wellbeing||Under 25s able to access specialist mental health services within three weeks of referral||Percentage of child and youth (under 25) accessing mental health services within three weeks of referral|
|Access to primary mental health and addiction services||In development|
|Improving wellbeing through prevention||Ambulatory sensitive hospitalisations for adults (age range 45-64)||Rate of hospital admissions for people aged 45–64 for an illness that might have been prevented or better managed in the community|
|Participation in the bowel screening programme||In development|
|Strong and equitable public health system||Acute hospital bed day rate||Number of days spent in hospital for unplanned care including emergencies|
|Access to planned care||People who had surgery or care that was planned in advance, as a percentage of the agreed number of events in the delivery plan|
|Better primary health care||People report they can get primary care when they need it||Percentage of people who say they can get primary care from a GP or nurse when they need it|
|People report being involved in the decisions about their care and treatment||Percentage of people who say they felt involved in their own care and treatment with their GP or nurse|
|Financially sustainable health system||Annual surplus/deficit at financial year end||Net surplus/deficit as a percentage of total revenue|
|Variance between planned budget and year end actuals||Budget versus actuals variance as a percentage of budget|
Reporting on the indicators
Results for the Health System Indicators are published quarterly on a web-based dashboard hosted by the Commission.
The first update of the Health System Indicators was added in December 2021. This shows change from baseline for most of the high-level indicators and adds a view for each district health board (DHB). The baseline for improvement for most indicators is December 2019, as more recent data has been significantly affected by the COVID-19 response so are not appropriate to use as a baseline.
COVID-19 and the associated health response is impacting on many of the indicators reported and explain much of the apparent improvements or reductions from baseline. These highlight areas to watch where there may be a rebound as a result of delayed care (for example, in ambulatory sensitive hospitalisations) or a need for targeted activity to address gaps (for example, 24-month immunisations).
Full implementation of the framework involves areas developing local solutions to local problems, with an emphasis on continuous improvement at a local level to lift overall health system performance. This early in the development of the framework, and prior to full implementation of the local actions, caution is needed in the interpretation of the results.
The Ministry of Health and the Health Quality & Safety Commission continues to work with the Health and Disability Review Transition Unit and sector stakeholders during 2021/22 to further develop the framework and ensure it complements overarching monitoring and accountability arrangements for the health and disability system going forward.