System Level Measures


What are System Level Measures?

System Level Measures are high-level goals for the health system that help show the outcomes of the system – how it is performing and the value the country is receiving from it. For example, the measure ‘Acute hospital bed days per capita’ shows how effectively health resources are being used. This measure is affected by good upstream primary care, discharge planning, and good ongoing communication about a person’s care between hospital and community care.

Contributory measures have a quality improvement focus and are front line service level measurements that show a tangible and meaningful result of the interaction between clinicians and patients. They are locally chosen based on the needs and priorities of communities and district level health services. For example, contributory measures for ‘Acute hospital bed days per capita’ could include length of stay, acute readmissions and flu vaccinations in the elderly.

The Measures Library for System Level and contributory measures is available on Health Quality Measures New Zealand.

Why the framework is no longer called Integrated Performance and Incentive Framework (IPIF)?

While IPIF focused mainly on primary care, the focus has now been broadened to include the whole health system. This broader focus reflects the vision of the IPIF Expert Advisory Group report and the priorities of the updated New Zealand Health Strategy. The System Level Measures Framework has provided the opportunity for IPIF to evolve into the system level performance measurement envisioned in the Strategy

What are the System Level Measures for 2016/17?

The four new System Level Measures implemented from 1 July 2016 are:

  1. Ambulatory Sensitive Hospitalisation (ASH) rates per 100,000 for 0–4 year olds (ie, Keeping children out of the hospital)
  2. Acute hospital bed days per capita (ie, Using health resources effectively)
  3. Patient experience of care (ie, Person-centred care)
  4. Amenable Mortality rates (ie, Prevention and early detection)

The following two System Level Measures are being developed for implementation from 1 July 2017:

  1. Proportion of babies who live in a smoke-free household at six weeks post natal (ie, Healthy start)
  2. Youth access to and utilisation of youth appropriate health services (ie, Teens make good choices about their health and wellbeing).

Refer to the System Level Measures newsletters for an update on the development of these measures.