Australia has no national minimum data set for primary health care.
This means that no comprehensive, ongoing data set exists in this country that can show how and why people use and access primary health care services, what occurs in individual consultations, and the resulting health outcomes. This is despite substantial government and individual investment in primary health care services.
For a health system to effectively and efficiently meet the needs and expectations of Australians, data collection and reporting in primary health care is essential. We need to be able to monitor changes and improvements in primary care services over time and understand the impact of different care models for those at risk of poor health.
The Deeble Institute for Health Policy Research’s recent paper Call for the establishment of a primary health care national minimum data set, by Maddy Thorpe and Sharon Sweeney of Brisbane South Primary Health Network (PHN), has highlighted that the ongoing collection of data from general practice using standardised definitions and coding would create enormous benefits for service planning and delivery.
Whistling in the dark
PHNs were established to increase the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes, and to improve the coordination of care so that patients would receive the right care in the right place at the right time. While PHNs have many achievements and innovations to be proud of so far, without comprehensive and consistent primary care data they will be whistling in the dark in the longer term.
Fortuitously, a national mechanism has been recently set up to lead national primary healthcare data development – the National Primary Health Care Data Unit at the Australian Institute of Health and Welfare (AIHW).
We are calling on the Australian Government to capitalise on this initiative and back the AIHW to the greatest extent possible to lead the development of a Primary Health Care National Minimum Data Set.
Crystal clarity needed
In so doing, AIHW needs to be crystal clear in communicating why the data are being collected. The Institute will also need to be mindful of the practicalities associated with collection of the data, the need for appropriate workforce development and training, and the need to address consumer issues and to assure privacy and security of the data.There is also a strong need for alignment with other national data sets in health through a national data governance framework.
To be effective and useful to PHNs, a primary health care national minimum data set must include standardised data on:
- provider demographics to facilitate workforce planning
- patient demographics to support identification and monitoring of health issues of concern for specific groups and understand inflows and outflows of patients between PHN regions and local services
- patient health status and health-related behaviours to:
- assist with local planning and targeting of health needs
- monitor risk behaviours in local regions
- identify areas for quality improvement
- patient encounters to understand why people use primary health care services and to monitor utilisation trends across healthcare services within a region, and
- health outcomes to assist in evaluating the effectiveness and efficiency of primary health care service delivery.
Without NMDS, improvements difficult
Primary healthcare data will not, of itself, solve the increasing pressures on our health system. But without good data, we cannot fully understand what is happening in primary health care, we cannot monitor changes from a baseline understanding of the status quo, and we will have only a limited understanding of the relationships between primary care and other elements of the health system. Making worthwhile improvements under this scenario is extremely difficult, if not impossible.
It is a false comfort that globally there are few examples of data being routinely and consistently collected about what happens in general practice consultations. Australia can get ahead of the game in 2019 by fully supporting the AIHW and its National Primary Health Care Data Unit to accelerate the establishment of a national minimum data set for primary healthcare.
Dr Rebecca Haddock is Director of the Deeble Institute for Health Policy Research. Nigel Harding is Public Affairs Manager of the Australian Healthcare and Hospitals Association.