Health System Indicators framework

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 has been developed by the Ministry of Health and the Health Quality & Safety Commission (the Commission). It builds on the System Level Measures programme that was co-designed with the health and disability sector. The Commission has developed an online dashboard for reporting improvements on the Health System Indicators.

This new framework identifies high level indicators of performance while taking into account that every community has different health challenges. The emphasis is on continuous improvement at a local level to lift overall health system performance, rather than on achieving nationally-set performance targets.

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. Local solutions for different parts of the country will be developed, measured and tracked to ensure positive change on each of the indicators.

The high-level Health System Indicators are:
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 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.

National data up to 31 March 2021 are available now. First quarter results for 2021/22 will be available in December 2021 for most indicators. 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.

Next steps

The Ministry of Health and the Commission will 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.

DHBs and local providers will be supported during 2021/22 to partner with their stakeholders including Māori/Iwi partnership boards and clinicians to develop a set of local actions for each high-level indicator that will contribute to national improvement.

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