CSIRO Publishing blank image blank image blank image blank imageBooksblank image blank image blank image blank imageJournalsblank image blank image blank image blank imageAbout Usblank image blank image blank image blank imageShopping Cartblank image blank image blank image You are here: Journals > Australian Health Review   
Australian Health Review
  Journal of the Australian Healthcare & Hospitals Association
blank image Search
blank image blank image
blank image
  Advanced Search

Journal Home
About the Journal
Editorial Structure
For Advertisers
Online Early
Current Issue
Just Accepted
All Issues
Sample Issue
For Authors
General Information
Author Instructions
Submit Article
Open Access
For Referees
Referee Guidelines
Review an Article
Annual Referee Index
Call for Reviewers
For Subscribers
Subscription Prices
Customer Service
Print Publication Dates

blue arrow e-Alerts
blank image
Subscribe to our Email Alert or RSS feeds for the latest journal papers.

red arrow Connect with AHR
blank image

red arrow Connect with AHHA
blank image
facebook TwitterIcon

red arrow Connect with CP
blank image
facebook twitter LinkedIn


Article << Previous     |     Next >>   Contents Vol 38(1)

Establishing the value of Indigenous eye health programs: health needs, economic priority and performance assessment approaches

David Dunt A C , Mitchell Anjou B , Andrea Boudville B , Arthur Hsueh A and Hugh Taylor B

A Centre for Health Policy, Programs and Economics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Vic. 3110, Australia. Email: ahsueh@unimelb.edu.au
B Indigenous Eye Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Vic. 3110, Australia. Email: manjou@unimelb.edu.au, andrea@unimelb.edu.au, h.taylor@unimelb.edu.au
C Corresponding author. Email: d.dunt@unimelb.edu.au

Australian Health Review 38(1) 99-105 http://dx.doi.org/10.1071/AH13132
Submitted: 2 July 2013  Accepted: 30 September 2013   Published: 6 December 2013

PDF (449 KB) $25
 Export Citation

Objectives The aim of this paper was to compare three different approaches that are used in support of additional funding of health programs, using Indigenous eye health programs (IEHPs) as an example. These approaches are Heath and Health Care Needs, Economic Priority (Value for Money) and Conformity with Health Services Performance Standards.

Methods A review of relevant literature was conducted to identify relevant benchmarks and assess IEHPs.

Results In terms of health needs, vision loss is the fourth highest contributor to the Indigenous health gap. Additional funding for Indigenous eye treatment services to remove the gap is estimated at A$28.1 million per annum. As an economic priority, IEHPs (specifically for refractive error, cataract, diabetic retinopathy and trachoma) demonstrate excellent value for money and compare favourably with other better-researched health programs. Evaluation of health performance measures indicated that IEHPs also perform well, as judged by Australian performance standards for health services generally and Indigenous health services more specifically, the later involving local delivery, including care coordination through Aboriginal-controlled community health services.

Conclusion The value of IEHPs was demonstrated using all three approaches. Different approaches are likely to be more or less persuasive with different audiences. The application of these approaches is relevant to other health programs.

What is known about this topic? Supporters of additional funding for health programs frequently use the impact of this additional funding on the health and health care needs of the affected populations and individuals. Indigenous Eye Health programs are considered for illustrative purposes. This argument is not necessarily persuasive to funders of health programs.

What does this paper add? This paper demonstrates that two further approaches, namely Economic Priority and Conformity with Health Performance Measure Standards, both demonstrate good arguments in support of additional funding and that these outcomes may be more persuasive to funders of health programs.

What are the implications for practitioners? Practitioners are able to harness additional approaches with a higher likelihood of success of submissions for additional funding for the program they are promoting.


[1]  Vos T, Mitchell H. Contribution of vision loss to the Indigenous health gap. Clin Exp Ophthalmol 2013; 41: 309–10.
CrossRef |

[2]  Taylor HR, Anjou MD, Boudville AI, McNeil RJ. The roadmap to close the gap for vision, full report . Melbourne: Indigenous Eye Health Unit; 2012.

[3]  Australian Institute of Health and Welfare (AIHW). The health and welfare of Australia’s Aboriginal and Torres Strait Islander people: an overview, 2011. Catalogue no. IHW 42. Canberra: AIHW; 2011.

[4]  Donaldson C, Mooney G. Needs assessment, priority setting, and contracts for health care: an economic view. BMJ 1991; 303: 1529–30.
CrossRef | CAS | PubMed |

[5]  Vos T, Carter R, Barendregt J, Mihalopoulos C, Veerman JL, Magnus A, et al. Assessing Cost-Effectiveness in Prevention (ACE–Prevention): final report. Brisbane and Melbourne: University of Queensland and Deakin University; 2010.

[6]  Wright J, Kyle D. Assessing health needs. In D Pencheon, C Guest, D Melzer, JAM Gray (Eds). Oxford handbook of public health practice. Oxford: Oxford University Press; 2003. Chapter 1.3.

[7]  Bradshaw J. A taxonomy of social need. A taxonomy of social need. New Soc 1972; 496: 640–3.

[8]  Stevens A, Raftery J, Mant J. Introduction. In A Stevens, J Raftery (Eds). Health care needs assessment: the epidemiologically based needs assessment reviews. Oxford: Radcliffe Medical Press; 1994; 1–16.

[9]  Taylor HR, Pezzullo ML, Keeffe JE. The economic impact and cost of visual impairment in Australia. Br J Ophthalmol 2006; 90: 272–5.
CrossRef | CAS | PubMed |

[10]  VISION 2020. Clear focus the economic impact of vision loss in Australia in 2009. An overview of the report prepared for Vision 2020 Australia by Access Economics Pty Ltd. Melbourne: Vision 2020; 2010.

[11]  Henry B. A conceptualisation of ‘the good’ in economic evaluation of Aboriginal health policy. Perth: Curtin University; 2004.

[12]  Centre for Eye Research Australia. National Indigenous eye health survey minum barreng (tracking eyes): full report. Melbourne: Centre for Eye Research Australia; 2009.

[13]  Kelaher M, Ferdinand A, Ngo S, Tambuwla N, Taylor HR. Access to eye health services among Indigenous Australians: an area level analysis. Melbourne: Centre for Health Policy, Programs and Economics and Indigenous Eye Health Unit, Melbourne School of Population Health, The University of Melbourne; 2010.

[14]  Hsueh Y, Brando A, Dunt D, Anjou M, Taylor H. The cost to close the gap for vision. Melbourne: Indigenous Eye Health Unit, The University of Melbourne; 2011.

[15]  Petrou S. Health needs assessment is not required for priority setting. BMJ 1998; 317: 1154.
CrossRef | CAS | PubMed |

[16]  Finkelstein A, Taubman S, Wright B, Bernstein M, Gruber L, Newhouse JP, et al. The Oregon Health Insurance Experiment: evidence from the first year . NBER Working Paper No. 17190. Cambridge, MA: National Bureau of Economic Research; 2011.

[17]  Chapman RH, Stone PW, Sandberg EA, Bell C, Neumann PJ. A comprehensive league table of cost-utility ratios and a sub-table of ‘panel-worthy’ studies. Med Decis Making 2000; 20: 451–67.
CrossRef | CAS | PubMed |

[18]  Ong KS, Kelaher M, Anderson I, Carter R. A cost-based equity weight for use in the economic evaluation of primary health care interventions: case study of the Australian Indigenous population. Int J Equity Health 2009; 8: 34–52.
CrossRef | PubMed |

[19]  Ong KS, Carter R, Kelaher M, Anderson I. Differences in primary health care delivery to Australia’s Indigenous population: a template for use in economic evaluations. BMC Health Serv Res 2012; 12: 307.
CrossRef | PubMed |

[20]  National Coalition for Vision Health. Foundation for a Canadian vision health strategy. 2007. Available at http://ebookbrowse.com/foundations-for-a-canadian-vision-health-strategy-pdf-d24321082 [verified 13 September 2012]

[21]  Baltussen R, Smith A. Cost effectiveness of strategies to combat vision and hearing loss in sub-Saharan Africa and South East Asia: mathematical modelling study. BMJ 2012; 344: e615.
CrossRef | PubMed |

[22]  Chisholm D, Baltussen R, Evans DB, Ginsberg G, Lauer JA, Lim S, et al What are the priorities for prevention and control of non-communicable diseases and injuries in sub-Saharan Africa and South East Asia? BMJ 2012; 344: e586.
CrossRef | CAS | PubMed |

[23]  Solomon AW. Don’t let misinformation derail the trachoma elimination programme. BMJ 2012; 344: e2588.
CrossRef | PubMed |

[24]  National Health Performance Committee. National health performance framework. 2009. Available at http://meteor.aihw.gov.au/content/index.phtml/itemId/392569 [verified 13 September 2012]

[25]  Australian Health Ministers’ Advisory Committee (AHMAC). Aboriginal and Torres Strait Islander health performance framework–2008 report. Canberra: AHMAC; 2008.

[26]  Segal L, Chen Y. Priority setting for health a critique of alternative models. Report to the Population Health Division, Department of Health and Aged Care. Melbourne: Centre for Health Program Evaluation; 2001.

[27]  Dixon J, Welch HG. Priority setting: lessons from Oregon. Lancet 1991; 337: 891–4.
CrossRef | CAS | PubMed |

[28]  Lopez AD, Murray CJL. The global burden of disease, 1990–2020. Nat Med 1998; 4: 1241–3.
CrossRef | CAS | PubMed |

[29]  Turner AW, Mulholland WJ, Taylor HR. Coordination of outreach eye services in remote Australia. Clin Exp Ophthalmol 2011; 39: 344–9.
CrossRef |

[30]  Turner AW, Mulholland WJ, Taylor HR. Funding models for outreach ophthalmology services. Clin Exp Ophthalmol 2011; 39: 350–7.
CrossRef |

Subscriber Login


Legal & Privacy | Contact Us | Help


© CSIRO 1996-2015