Introduction

As part of the National Indigenous Reform Agreement (NIRA), the Council of Australian Governments (COAG) agreed that the Department of Health and Ageing, in partnership with the state and territory health departments and in collaboration with the Australian Institute of Health and Welfare (AIHW), would develop a set of national key performance indicators (KPIs) for Indigenous specific primary health care services. AIHW have provided specifications for these indicators. More information can be found on their website http://www.aihw.gov.au/indigenous-primary-health-care-nkpi/

The CAT National KPI module is available in CAT4 , for clinical systems where the CAT data extract meets the CAT data specifications version 1_6 or higher Indicators PI01 and PI02 are only available for CAT data specifications version 1_10 or higher
Indicator PI13 is only available for CAT data specifications version 1_15 or higher or Communicare v13.2. The module provides:

• A summary indicator report
• An extended indicator report which provides additional breakdown by age and gender
  
  
  The Standard NKPI Report displays data for regular clients as defined by AIHW.
  
  MBS Item Indicators in the report (indicators P103, P107 and P108) are available where the clinical and billing systems are provided by the same vendor or are supported by CAT.

About this Guide

This guide provides a description of each indicator in the report. The 'CAT User Guide Appendices Data Mappings' provides an explanation of where most of the data items are collected from in each clinical system. This guide provides any additional explanations required and details of any calculations used.

Notes:
1) A regular client is a patient who has visited the health service at least 3 times in the past 2 years.
2) A visit is any patient contact that has been recorded in the progress notes.
3) Reporting at 30/06/2012 includes inactive/archived patients
4) Reporting at 31/12/2012 includes inactive/archived patients and deceased patients Extract files dated from 1^st November 2012 will include deceased patients. This will be indicated at the top of the report.

National KPI Report                                                        

The Report is available under Standard Reports > Indicator Sets

A button Show Extended/Show Summary is used to toggle between the Summary and Extended Indicator Reports. In the                           

extended view the report shows all indicators by age group, gender and ethnicity

Indicator Descriptions

PI01 Birth weight recorded

The Proportion of Indigenous babies born in the last 12 months whose birth weight has been recorded in the baby's medical record.
Birth weight is defined as the first weight of a baby obtained after birth and must be recorded with the same date as the baby's birth date.

 

In the CAT filters set the following:

1. Ethnicity tab >"Indigenous" checkbox ticked 
   1. Results tab > select results "<=12 mths"
    

   Click Recalculate
   In the CAT graphs open the Maternal Health Care > Baby Birth Weight > Patient Record tab
   Select 'Not Recorded' segment
   Click Export

PI02 Birth weight recorded as low, normal or high

The Proportion of Indigenous babies born in the last 12 months whose birth weight has been recorded in the baby's medical record and

whose weight is categorised as low, normal or high.

 
Birth weight is defined as the first weight of a baby obtained after birth and must be recorded with the same date as the baby's birth date.

Weight categories are defined as:

Weight

Grams

Low

< 2500g

Normal

2500 - <4500

High

>= 4500

How to find patients with each specified weight

using CAT

PI03 Indigenous Health Assessments  (MBS 715)

Calculation A: Regular Indigenous clients who have had a health check done in the last 12 months

• 0-4 years
  
  
  Calculation B: Regular Indigenous clients who have had a health check done in the last 24 months

• Male/Female, and

• 25-34 years
• 35-44 years
• 45-54 years
• 55-64 years
• >= 65 years

Note: MBS Item Indicators in the report are available where the clinical and billing systems are provided by the same vendor.                          

How to find patients with missing data using CAT

 Calculation A:

  In the CAT filters set the following:

General tab >

"End Age" = 4,
"Active" checkbox ticked

Ethnicity tab >

"Indigenous" checkbox ticked

Results tab > select results "<=12 mths"

Click Recalculate
In the CAT graphs open the MBS Item > Not Recorded tab
Select all "715" bars
Click Export 

General tab >

"Start Age" = 25
"Active" checkbox ticked

Ethnicity tab >

"Indigenous" checkbox ticked

Results tab >

select results "<=24 mths"

Click Recalculate
In the CAT graphs open the MBS Item > Not Recorded tab
Select all "715" bars
Click Export
NOTE: old MBS health assessment numbers (pre May 10) are considered here if they have been billed in

the last 24 months

PI04 Indigenous Children who are Fully Immunised

Regular Indigenous children who are fully immunised

• At 12 months – ages 12 months to < 24 months
• At 24 months – ages 24 months to < 36 months

At 60 months – ages 60 months to < 72 months


Fully immunised: Children who have received all immunisations that are due according to the National Immunisation Program Schedule   

http://www.health.gov.au/internet/immunise/publishing.nsf/content/nips2
or Australian Standard Vaccination www.immunise.health.gov.au for the immunisations DTPa, HiB,

Polio, HepB and MMR. Immunisations to be received on or before last birthday.
 

Overdue Immunisations: In the worksheet of the NKPI Essential Immunisations report the overdue vaccine is indicated by an *

next to the number

Age Range

Last Birthday

Immunisations due last birthday

HepB

DTPa

Hib[1]

IPV

MMR

12 - <24mths

12 months

3[2]

3

2 or 3

3

24 - <36mths

24months

3

3

3 or 4

3

1

60 - < 72mths

60 months

3

4

3 or 4

4

2

How to find patients with missing immunisations using CAT

In the CAT filters set the following:

General tab >

 “Active” checkbox ticked

Ethnicity tab >

“Indigenous” checkbox ticked

Click Recalculate

In the CAT graphs open the Immunisations > Child >Child nKPI Essential Immunisations tab                                                                     

This graph only displays children aged 1,2 and 5.

Select the segment ‘Not Fully Immunised’

Click Worksheet

The worksheet will display the number of doses received for the nKPI essential immunisations DTPa,

HiB, Polio, HepB and MMR at

the child’s last birthday. An * is displayed next to the dose number of the vaccine that is overdue

PI05 Diabetes II HbA1c Recorded                    

Calculation A: Regular Indigenous clients with Type II Diabetes who have had an HbA1c recorded in the last 6 months.                                          
Calculation B: Regular Indigenous clients with Type II Diabetes who have had an HbA1c recorded in the last 12 months.

• Male/Female, and

• 0-4 years
• 5-14 years
• 15-24 years
• 25-34 years
• 35-44 years
• 45-54 years
• 55-64 years
• >= 65 years

Calculation A:

In the CAT filters set the following:

General tab >  “Active” checkbox ticked

Ethnicity tab > “Indigenous” checkbox ticked

Conditions tab > Diabetes Type II ticked

Results tab > select results “<=6 mths”

Click Recalculate

In the CAT graphs open the Pathology > HbA1c tab                                                                                                               

Select the “No HbA1C Recorded” segment

Click Export

Calculation B:

In the CAT filters set the following:

General tab >  “Active” checkbox ticked

Ethnicity tab > “Indigenous” checkbox ticked

Conditions tab > Diabetes Type II ticked

Results tab > select results “<=12 mths”

Click Recalculate

In the CAT graphs open the Pathology > HbA1c tab

Select the “No HbA1C Recorded” segment

Click Export

PI06 Diabetes II HbA1c Level

Calculations A-D: Regular Indigenous clients with Type II Diabetes who have had an HbA1c recorded in the last 6 months and whose result     
was in the following ranges:
A. <=7; B. >7 and <=8; C. >=8 and < 10; D. >=10

Calculations E-H: Regular Indigenous clients with Type II Diabetes who have had an HbA1c recorded in the last 12 months and whose

result was in the following ranges.
E. <=7; F. >7 and <=8; G. >=8 and < 10; H. >=10

• Male/Female, and

• 0-4 years
• 5-14 years
• 15-24 years
• 25-34 years
• 35-44 years
• 45-54 years
• 55-64 years
• >= 65 years

PI07 Patients on GPMP (MBS 721)

a) Diabetes
Regular Indigenous clients with Type II Diabetes who have had a GP Management Plan (MBS Item 721) done in the last 24 months.

• Male/Female, and

• 0-4 years
• 5-14 years
• 15-24 years
• 25-34 years
• 35-44 years
• 45-54 years
• 55-64 years
• >= 65 years

In the CAT filters set the following:

General tab >  “Active” checkbox ticked

Ethnicity tab > “Indigenous” checkbox ticked

Conditions tab > Diabetes Type II ticked

Results tab > select results “<=24 mths”

Click Recalculate

In the CAT graphs open the MBS Items > Not Recorded tab

Select the “721(CDM-GPMP)” segment

Click Export

PI08 Patients on Teamcare Arrangement
(MBS 723)

a) Diabetes
Regular Indigenous clients with Type II Diabetes who have had a GP Management Plan (MBS Item 723) done in the last 24 months.                   

• Male/Female, and

• 0-4 years
• 5-14 years
• 15-24 years
• 25-34 years
• 35-44 years
• 45-54 years
• 55-64 years
• >= 65 years

In the CAT filters set the following: 

General tab > "Active" checkbox ticked 

Ethnicity tab > "Indigenous" checkbox ticked 

Conditions tab > Diabetes Type II ticked

Results tab > select results "<=24 mths"

PI09 Smoking status recorded                        

Regular Indigenous clients who have a smoking status recorded                                                                                                                                          

• Male/Female, and

• 15-24 years
• 25-34 years
• 35-44 years
• 45-54 years
• 55-64 years
• >= 65 years

In the CAT filters set the following: 

General tab >  "Start Age" = 15

"Active" checkbox ticked 

Ethnicity tab > "Indigenous" checkbox ticked 

Conditions tab > Diabetes Type II ticked

In the CAT graphs open the Smoking tab select the "Nothing Recorded" segment
Click Export

PI10 Smoking Status Result                                    

Regular Indigenous clients whose smoking status has been recorded as                                                                                                                           

1. 'Current Smoker'
2. 'Ex Smoker'
3. 'Never Smoked'
   
   
   Extended report breakdown by:

Male/Female, and

• 15-24 years
• 25-34 years
• 35-44 years
• 45-54 years
• 55-64 years
• >= 65 years

How to find patients with each specified                 

status using CAT

PI11 Smoking During Pregnancy

Proportion of regular Indigenous clients aged 15 and over who gave birth within the previous 12 months and whose smoking status has       
been recorded.
The report will show the number and percentage of patients by smoking status as
'Current Smoker', 'Ex Smoker' or 'Never Smoked'

Extended report breakdown by:

• 15-19 years
• 20-24 years

How to find patients with each specified                 

status using CAT

In the CAT filters set the following:

General tab > “Start Age” = 15

“Active” checkbox ticked

Ethnicity tab > “Indigenous” checkbox ticked

Click Recalculate

• In the CAT graphs open the “Maternal Health Care” tab and then the “Date of First Visit” graph. Click   
  the “Select All” checkbox
• Go to the “Smoking” graph and select the part(s) of the graph you want to investigate, for example
  “Daily Smokers”
• Click on “Report” on the top of your screen to create a cross tabulation report. This will show any
  women who have given
•  birth and match your selection on the “Smoking” graph

PI12 BMI classified as overweight or obese

Regular Indigenous clients who have had their BMI recorded in the last 24 months and whose BMI was classified as:                                           
A. Overweight (>= 25 and < 30); B. Obese (>=30)

Where BMI is calculated from height and weight, both components must be recorded in the last 24 months

• Male/Female, and

• 25-34 years
• 35-44 years
• 45-54 years
• 55-64 years
• >= 65 years
  

In the CAT filters set the following:

General tab >  “Start Age” = 25

“Active” checkbox ticked

Ethnicity tab > “Indigenous” checkbox ticked

Results tab > select results “<=24 mths”

Click Recalculate

In the CAT graphs open the Measures > BMI > Incomplete tab                                                                                             

Select all segments

Click Export

PI13 Timing of First Antenatal Care Visit

The Proportion of regular Indigenous women who gave birth in the last 12 months, attended antenatal care and whose first antenatal

care visit had the clinical gestation age (in weeks) recorded

1. < 13 wks
2. 13wks – <20 wks
3. >= 20 wks
4. Not Recorded
5. No visit recorded
   
   
   Counting:
   a) Date of birth <= 12mths and
   b) Birth weight > 400g or Gestation > 20 weeks

Antenatal visit record provides a calculated gestational age and allows a clinical gestational age to be entered.

If a clinical value is entered this will be used in preference to the calculated value.

Extended report breakdown by:

• <20 years
• 20-34 years
• >= 35 years

General tab > "Active" checkbox ticked
Gender "Female" checkbox ticked

Ethnicity tab >

PI14 Influenza Immunisation in patients 50 years and over

Regular Indigenous clients with age >= 50 years who have been immunised against influenza in the last 12 months.                           

Extended report breakdown by:

• Male/Female, and

• >= 50 years

General tab > enter

"Start Age" = 50
"Active" checkbox ticked

Ethnicity tab >

PI15 Influenza Immunisation in patients with Diabetes II

or COPD aged 15 to 49 years

Regular Indigenous clients aged 15-49 years who have been immunised against influenza in the last 12 months who are diagnosed   
with

1. Type II Diabetes
2. COPD
   
   
   Extended report breakdown by:

• Male/Female, and

• 15-24 years
• 25-34 years
• 35-44 years
• 45-49 years

General tab > "Start Age" = 15
"End Age" = 49
"Active" checkbox ticked

Ethnicity tab > "Indigenous" checkbox ticked

Conditions tab > Diabetes Type II ticked

Click Recalculate
In the CAT graphs open the Immunisations > Influenza tab                                                                                         
Select all segments except "<= 1 yr"

Click Export

General tab > "Start Age" = 15
"End Age" = 49
"Active" checkbox ticked

Ethnicity tab > "Indigenous" checkbox ticked

Conditions tab > COPD

PI16 Alcohol consumption status recorded                       

Regular Indigenous clients who have an alcohol consumption status recorded (status and/or amount/frequency) in the last 24 months 

Male/Female, and

• 15-24 years
• 25-34 years
• 35-44 years
• 45-54 years
• 55-64 years
• >= 65 years

General tab > "Start Age" = 15
"Active" checkbox ticked

Ethnicity tab > "Indigenous" checkbox ticked

Results tab > select results "<=24 mths"

Number of regular Indigenous clients, aged 15 years and over, who have had an AUDIT-C result recorded in the previous 24 months      

with a score of:

• greater than or equal to 4 in males and 3 in females; or
• less than 4 in males and 3 in females. 

This indicator has two tables, one for male and one for female patients.

Male/Female, and                                                                       

• 15-24 years
• 25-34 years
• 35-44 years
• 45-54 years
• 55-64 years
• >= 65 years

How to find patients with missing data using CAT 
                                                                  

Use the new NPKI graph Alcohol AUDIT-C Results on the Chronic Disease Risk Factors page to see a the results represented in a graph  

and double click on the part of the graph 

(M:Score<4, F:Score<3 or M:Score>=4, F:Score>=3 to see the patient details. No filters are required

PI18 Kidney function test in patients with Diabetes II

or CVD

Regular Indigenous clients aged >=15 years who have had a kidney function test in the last 12 months who are diagnosed with                 

A: Type II Diabetes

Kidney function tests included are

a)eGFR only

b) ACR ACR or other microalbumin test (includes microalbumin spot test, albumin urinary excretion and            
albumin urininary excretion 24hr) only

c) eGFR and ACR

d) Not Recorded

B: CVD

Kidney function tests included are

a) eGFR

b) Not Recorded

• Male/Female, and

Extended report breakdown by:
 

• 15-24 years
• 25-34 years
• 35-44 years
• 45-54 years
• 55-64 years
• >= 65 years

Calculation A:

In the CAT filters set the following:

1)     General tab >  “Active” checkbox ticked

2)     Ethnicity tab > “Indigenous” checkbox ticked

3)     Conditions tab > Diabetes Type II ticked

4)     Results tab > select results “<=12 mths”

Click Recalculate

In the CAT graphs open the Pathology > eGFR, ACR, Microalbumin tabs                                                                      

Select the “No Data’ segment on each graph

Click Report (under top menu bar)

Calculation B:

In the CAT filters set the following:

1)     General tab >  “Active” checkbox ticked

2)     Ethnicity tab > “Indigenous” checkbox ticked

3)     Conditions tab > Cardiovascular Disease (CVD) ticked

4)     Results tab > select results “<=12 mths”

Click Recalculate

In the CAT graphs open the Pathology > eGFR tab

Select the “No Data’ segment

Click Export

PI19 Kidney function test results in patients
with Type II Diabetes or CVD

The proportion of regular Indigenous clients, aged 15 years and over who are recorded as  having Type II Diabetes and/or CVD who have

had an estimated glomerular filtration rate (eGFR) recorded within the previous 12 months. The results are represented in a table

showing the following values as numbers and percentage of the total:

1. >= 90
2. >= 60 and < 90
3. >= 45 and < 60
4. >= 30 and < 45
5. >= 15 and < 30
6. <15
   
   
    

Calculation A (clients with Diabetes)                                                                                                                                    

In the CAT filters set the following:

General tab > Age

Start age = 15 Yrs

Ethnicity tab > “Indigenous” checkbox ticked

Conditions tab > Diabetes Type II ticked

Results tab > select results “<=12 mths”

Click Recalculate

In the CAT graphs open the Pathology > eGFR tab

Select the “No Data’ segment on the graph

Click Export

Calculation B (clients with CVD)

In the CAT filters set the following:

General tab > Age

Start age = 15 Yrs

Ethnicity tab > “Indigenous” checkbox ticked

Conditions tab > Cardiovascular Disease ticked

Results tab > select results “<=12 mths”

Click Recalculate

In the CAT graphs open the Pathology > eGFR tab

Select the “No Data’ segment on the graph

Click Export

Proportion of Indigenous clients aged 35 to 74 years who are regular clients of the service, without a diagnosis of CVD, who have had the

necessary risk factors recorded to enable CVD assessment:

• Age
• Gender
• Systolic BP (<24mths)
• Total Cholesterol (<24mths)
• HDL (<24mths)
• Smoking Status
• Diabetes

Due to the large number of different risk factors involved in this indicator you will have to check the corresponding reports as listed:

In the CAT filters set the following:                                                                                                                                        

For missing Age and Gender please refer to the guide at the end of this document. Follow that guide and add

Ethnicity tab > "Indigenous" checkbox ticked

Conditions tab > Chronic > CVD ' No' ticked

For missing BP, Cholesterol and HDL:

General tab> 'Active' box ticked

Start Age = 35, End Age = 74

Ethnicity tab > "Indigenous" checkbox ticked

Conditions tab > Chronic > CVD ' No' ticked

Date Range Result tab> <=24mths selected

For BP check the Measures>BP>No BP recorded part of the graph

For Cholesterol check the Pathology>Lipids>Cholesterol> No Cholesterol recorded part of the graph

For HDL check the Pathology>Lipids>HDL> No HDL recorded part of the graph

For missing Smoking Status:

General tab> 'Active' box ticked

Start Age = 35, End Age = 74

Ethnicity tab > "Indigenous" checkbox ticked

Conditions tab > Chronic > CVD ' No' ticked

Check the graph Smoking>Status> Nothing Recorded

Number of Indigenous regular clients, aged 35 to 74 years and with no known history of cardiovascular disease (CVD), who have had an  

absolute CVD risk assessment recorded within the previous 2 years and whose CVD risk was categorised as one of the following:

• High (greater than 15% chance of a cardiovascular event in the next 5 years)
• Moderate (10-15% chance of a cardiovascular event in the next 5 years)
• Low (less than 10% chance of a cardiovascular event in the next 5 years).

Use the new NPKI graph Absolute CVD Risk Result on the Chronic Disease Risk Factors page to see a the results represented in a graph    

and double click on the part of the graph 

• low risk (<10%)
• moderate risk (10-15%)
• high risk (>15%)
• not recorded

 to see the patient details. No filters are required

PI22 Cervical Screening

Proportion of Indigenous women aged 20-74 years who are regular clients of the service, who have had a cervical screening in the            

specified period (includes pap test prior to 1/12/2017 or HPV test from 1/12/2017)

1. 2 years
2. 3 years
3. 5 years
   
   Counting:
   Exclude patients who have had a hysterectomy

 A hysterectomy is indicated by either 1) a coded diagnosis of
hysterectomy recorded in the patient record or 2) the patient being marked for exclusion from further pap smears.

General tab > enter

“Active” checkbox ticked

Gender “Female” checkbox ticked

“Start Age” = 20

“End Age” = 74

Ethnicity tab > “Indigenous” checkbox ticked

Click Recalculate

a) In the CAT graphs open the Screening > Cervical Screening > Cervical Screening Last Recorded                      

Select the “Not Recorded” segment

b) Select HPV > 5yrs or Pap > 2yrs (no HPV)

Click Export

This will show a list of all indigenous women who are regular patients with either no cervical screening recorded or no HPV in the last five

years or no Pap smear in the last 2 years.

PI22 Cervical Screening                                                          

Proportion of Indigenous women aged 20-74 years who are regular clients of the service, who have had a cervical screening in the            

specified period (includes pap test prior to 1/12/2017 or HPV test from 1/12/2017)

• Female

• Last 2 years
• Last 3 years
• Last 5 years

Recorded/Not Recorded

PI23 Diabetes BP Recorded                                                   

Regular Indigenous clients with Type II Diabetes who have had BP recorded in the last 6 months                                                                        

• Male/Female, and

• 0-4 years
• 5-14 years
• 15-24 years
• 25-34 years
• 35-44 years
• 45-54 years
• 55-64 years
• >= 65 years

General tab > enter

"Active" checkbox ticked

Ethnicity tab > "Indigenous" checkbox ticked

Conditions tab > Diabetes Type II ticked

Results tab > select results "<=6 mths"

Click Recalculate
 

In the CAT graphs open the Measures > BP tab                                                                              
Select the "No BP Recorded" segment
Click Export

PI24 Diabetes BP Level                                                          

Regular Indigenous clients with Type II Diabetes who have had  BP recorded in the last 6 months and whose level was <=130/80                

• Male/Female, and

•  0-4 years
• 5-14 years
• 15-24 years
• 25-34 years
• 35-44 years
• 45-54 years
• 55-64 years
• >= 65 years

In the CAT filters set the following:

General tab > enter

“Active” checkbox ticked

Ethnicity tab > “Indigenous” checkbox ticked

Conditions tab > Diabetes Type II ticked

Results tab > select results “<=6 mths”

Click Recalculate

In the CAT graphs open the Measures > BP tab

Select the “>130/80 and <=140/90”, “>140/90” and “Incomplete Data” segments                     

Click Export

Missing Gender and/or Age Data                                      

Total counts for the following measures are also submitted:                                                                                                                                          

• Regular Indigenous clients without a gender or age recorded
• Regular Indigenous clients with a gender recorded but not an age
• Regular Indigenous clients with an age recorded but not a gender
• Regular Indigenous clients with both a gender and age recorded
  
  
  
   

Missing gender:

In the CAT filters set the following:

General tab > enter

 “Active” checkbox ticked

Ethnicity tab > “Indigenous” checkbox ticked                                                                                  

General tab > tick ‘Gender’ = Other

Click Recalculate

Click View Pop.

Missing age:

In the CAT filters set the following:

General tab > enter

 “Active” checkbox ticked

Ethnicity tab > “Indigenous” checkbox ticked

General tab > tick ‘Age’ = No Age

Click Recalculate

Click View Pop.

Further Information

Further information is available from http://www.aihw.gov.au
AIHW Metadata Online Registry http://meteor.aihw.gov.au