Report on Government Services

Definition

Framework Dimensions

• Effectiveness

  Effectiveness indicators measure how well the outputs of a service meet its delivery objectives. The reporting framework groups effectiveness indicators according to characteristics that are considered important to the service. For most sections, these characteristics include access, appropriateness and quality.

  Sub-dimensions of this dimension
  • Access

    Access indicators measure how easily the community can obtain a service. Access indicators can generally be categorised under three domains:

    • Overall access indicators show how readily services are accessed by those who need them across the eligible or relevant population (for example, access to specialist disability services is measured according to the ‘potential population’ based on disability rates). Due to difficulties in directly measuring access, indirect measures are often included, such as measures of unmet need or enrolment in preschool.
    • Timeliness of access indicators are important for services where there is limited supply of services, sometimes resulting in consumers experiencing delays accessing those services. For example, waiting times for health services, such as public dentistry and public hospitals.
    • Affordability indicators are included for service areas where consumers face at least part of the cost of the service and cost can be a barrier to obtaining the service. For example, the proportion of income spent on particular services, such as parents’ out-of-pocket cost of child care, or the proportion of people who delayed getting or did not get a prescription filled at any time in the previous 12 months due to cost.
    Indicators linked to this dimension
  • Appropriateness

    Appropriateness indicators measure how well services meet clients’ needs. Appropriateness is distinct from access, in that it is measuring performance in meeting the needs of people who already have access to the service. For example, whether students achieve their main reason for training.

    Appropriateness indicators also seek to identify whether the level of service received is appropriate for the level of need (HWA 2012; Birrell 2013). Some services have developed measurable standards of service need, against which levels of service can be assessed (for example, the ‘overcrowding’ measure in housing measures the appropriateness of the size of the dwelling relative to the size and composition of the household). Other services have few measurable standards of service need; for example, the desirable number of medical treatments for particular populations is not known.

  • Quality

    Quality indicators measure whether a service is suited to its purpose and conforms to specifications. Information about quality is particularly important when there is a strong emphasis on increasing efficiency. There is usually more than one way in which to deliver a service, and each alternative has different implications for both cost and quality. Information about quality is needed to ensure all relevant aspects of performance are considered.

    The approach in the Report is to identify and report on all aspects of quality including both actual and implied competence:

    • Actual competence can be measured by the frequency of positive (or negative) events resulting from the actions of the service.
    • Implied competence can be measured by proxy indicators, such as the extent to which aspects of a service conform to specifications.

    Quality indicators in the Report generally relate to one of four categories:

    • Standards — whether services are accredited and/or meeting required standards, such as legislation. For example, compliance with service standards for aged care services.
    • Safety — whether services provided are safe. For example, road safety and deaths in police custody.
    • Responsiveness — whether services are client orientated and respond to clients’ stated needs. For example, measures of patient satisfaction.
    • Continuity — whether services provide coordinated or uninterrupted care over time and across service providers. For example, community follow-up after psychiatric admission.
• Efficiency

  Economic efficiency requires satisfaction of technical, allocative and dynamic efficiency:

  • Technical efficiency requires that goods and services be produced at the lowest possible cost.
  • Allocative efficiency requires the production of the set of goods and services that consumers value most, from a given set of resources.
  • Dynamic efficiency means that, over time, consumers are offered new and better products, and existing products at lower cost.
  Sub-dimensions of this dimension
  • Inputs per output unit

    Technical efficiency indicators measure how well services use their resources (inputs) to produce outputs for the purpose of achieving desired outcomes. Government funding per unit of output delivered is a typical indicator of technical efficiency.

    Comparisons of the unit cost of a service are a more meaningful input to public policy when they use the full cost to government, accounting for all resources consumed in providing the service. Problems can occur when some costs are not included or are treated inconsistently (for example, superannuation, overheads or the user cost of capital).

• Equity

  Equity indicators measure how well a service is meeting the needs of particular groups that have special needs or difficulties in accessing government services. The equity–access indicators focus on measuring if services are equally accessible to everyone in the community regardless of personal characteristics such as cultural background or location. Effectiveness indicators can also have an equity dimension when the focus is on any gap in performance between special needs groups and the comparison/general population (for example, readmissions to hospital within 28 days of discharge, by Indigenous status). Equity of outcomes is also reported on under outcome indicators in some sections.

  Sub-dimensions of this dimension
  • Equity Access

    Equity indicators measure how well a service is meeting the needs of certain groups in society with special needs. Indicators may reflect both equity of access, whereby all Australians are expected to have adequate access to services, and equity of outcome, whereby all Australians are expected to achieve similar service outcomes.