Effective/Appropriate/Efficient3.01 Antenatal care
3.03 Health promotion
3.04 Early detection and early treatment
3.05 Chronic disease management
3.06 Access to hospital procedures
3.07 Selected potentially preventable hospital admissions
3.08 Cultural competency
Responsive3.09 Discharge against medical advice
3.10 Access to mental health services
3.11 Access to alcohol and drug services
3.12 Aboriginal and Torres Strait Islander people in the health workforce
3.13 Competent governance
Accessible3.14 Access to services compared with need
3.15 Access to prescription medicines
3.16 Access to after-hours primary health care
Continuous3.17 Regular GP or health service
3.18 Care planning for chronic diseases
3.20 Aboriginal and Torres Strait Islander people training for health-related disciplines
Sustainable3.21 Expenditure on Aboriginal and Torres Strait Islander health compared to need
3.22 Recruitment and retention of staff
Tier 3: Health System Performance includes measures that address effectiveness, appropriateness, efficiency, responsiveness, accessibility, continuity, capability and sustainability of the health system. The HPF also recognises that safety is a measure of health system performance, but this is reported by other frameworks (ACSQHC 2009). The new performance measure on cultural competency (see measure 3.08) addresses organisational, systemic and individual cultural competency in the health system. Accessibility shows measures of whether people have been able to access health care as needed. Continuity looks at pathways and barriers along the patient journey. The skills and knowledge of the people who work in the health system are described, as well as the infrastructure which enables the system to deliver services.
The HPF covers the entire health system, including Indigenous-specific services and programs, and mainstream services. The measures deal with a range of programs and service types including child and maternal health, health promotion, early detection and chronic disease management, continuous care, access to care, the health workforce and adequacy of resources.
All of the tiers in the HPF are inter-related and readers are encouraged to consider how measures interact. For example, measure 3.01 Antenatal care provides mothers with information and support which can reduce health risk behaviours during pregnancy (see measure 2.21) which in turn, is related to low birthweight (see measure 1.01).
Similarly, measure 3.21 Expenditure on Aboriginal and Torres Strait Islander health compared to need enhanced through awareness of issues outlined in measure 3.14 Access to services by types of service compared to need, and all of the measures outlined in Tier 1 which demonstrate the equity issues which underpin measures of effectiveness. Health workforce development hinges upon measures in Tier 2 such as educational attainment (see measures 2.04, 2.05 and 2.06).