THE AUSTRALIAN HEALTH CARE SYSTEM has an overarching objective to improve the well-being of all Australians in an equitable and efficient manner. But like most developed economy health care systems, it has experienced a continual increase in demand for health care services along with increased pressure to improve efficiency, quality, and sustainability. To assist in health sector management, policy formulation, investment decisions and reform, the Australian government developed the National Health Performance Framework (NHPF). The NHPF employs performance indicators across nine dimensions of health care, including Effectiveness, Appropriateness, Efficiency, Responsiveness, Accessibility, Safety, Continuity, Capability, and Sustainability. While the National Health Performance Committee has recognised that performance indicators used within the NHPF are inadequate, this thesis argues that the solution is not a simple matter of collecting additional data and constructing new and ???improved??? indicators. Due to resource constraints within the health care system there is an implicit performance trade-off across dimensions. The NHPF must take into consideration the value individuals place on the health care dimensions to enable a shift of limited resources to those areas that are most valued. The starting point for the NHPF should be to determine what society wants out of a health system. The purpose of this thesis is to determine Australian society???s preferences for performance across the nine NHPF dimensions of health care. This is achieved using a choice modelling experiment, which describes the performance of the current health care system and alternative health care systems the government could work towards, and asks respondents to compare and choose which system they prefer. A mixed multinomial logit model is used to analyse respondent choices in order to incorporate alternative tastes across attributes, and correlation of tastes across alternatives and scenarios. Relative values attached to the nine NHPF dimensions of health care are calculated and preferences for the dimensions are ranked. The thesis concludes by exploring individual preferences derived form the choice modelling experiment in the context of social welfare theory. It also outlines the strengths and weaknesses of the methodology, provides suggestions for further research, and offers a use for social preferences in the development of performance frameworks within the Australian health care system.
| Identifer | oai:union.ndltd.org:ADTP/258656 |
| Date | January 2009 |
| Creators | Cutler, Henry George, Economics, Australian School of Business, UNSW |
| Publisher | Awarded by:University of New South Wales. Economics |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
| Rights | Copyright Cutler Henry George., http://unsworks.unsw.edu.au/copyright |
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