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 BA 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
Submitted: 2 July 2013 Accepted: 30 September 2013 Published: 6 December 2013
Abstract
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.
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