Stephen Begg

Since 2006, the Australian Aboriginal and Torres Strait Islander Health Performance Framework (HPF) reports have provided information about Indigenous Australians’ health outcomes. The HPF was designed, in consultation with Indigenous stakeholder groups, to promote accountability and inform policy and research. This paper explores bridging the HPF as a theoretical construct and the publicly available data provided against its measures. A whole-of-framework, whole-of-system monitoring perspective was taken to summarise 289 eligible indicators at the state/territory level, organised by the HPF’s tier and group hierarchy. Data accompanying the 2017 and 2020 reports were used to compute improvement over time. Unit change and confidence indicators were developed to create an abstract but interpretable improvement score suitable for aggregation and visualisation at scale. The result is an exploratory methodology that summarises changes over time. An example dashboard visualisation is presented. The use of secondary data inevitably invites acknowledgments of what analysis cannot say, owing to methods of collection, sampling bias, or unobserved variables and the standard mantra regarding correlation not being causation (though no attempt has been made here to infer relationships between indicators, groups, or tiers). The analysis presented questions the utility of the HPF to inform healthcare reform.